Oncology

Research and

Treatment

Band 47 | Supplement 1 | Februar 2024

36. Deutscher Krebskongress

Fortschritt gemeinsam gestalten

21.–24. Februar 2024, Berlin

Herausgeber:

Reinhard Büttner, Köln

47 | S1 | 24

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Österreichische Gesellschaft für

Hämatologie & Medizinische Onkologie

Oﬃ cial Organ of Editors-in-Chief

Ralf-Dieter Hofheinz – Department of Medical Oncology, University Hospital Mannheim,

Heidelberg University, Mannheim, Germany

Sylvie Lorenzen – Third Department of Internal Medicine (Hematology/Medical Oncology),

Klinikum rechts der Isar, Technichal University Munich, Munich, Germany

Associate Editors

Carola Berking – Department of Dermatology, University Hospital Erlangen, Friedrich-Alexander-

University Erlangen-Nürnberg, Erlangen, Germany

Annalen Bleckmann – Department of Medicine A, Hematology, Oncology and Pneumology, Uni-

versity of Münster, Münster, Germany

Carsten Bokemeyer – Department of Oncology, Hematology and Bone Marrow Transplantation

with Division of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg,

Germany

Markus Borner – ONCOCARE am Engeriedspital, Bern, Switzerland

Andreas Burchert – Department of Hematology, Oncology and Immunology, University Hospital

Gießen and Marburg, Campus Marburg, Marburg, Germany

Jens Chemmitz – Internal Medicine, Hematology/Oncology, Palliative Medicine, Evangelisches

Stift St. Martin, Koblenz, Germany

Thomas Decker – Onkologie Hämatologie, Ravensburg, Germany

Hans Theodor Eich – Department of Radiation Oncology, University Hospital Münster, Münster,

Germany

Elena Elez – Medical Oncology Department, Vall d’Hebron Institute of Oncology (VHIO), Barcelona,

Spain

Yesim Erim – Department of Psychosomatic Medicine and Psychotherapy, University Hospital of

Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany

Markus Essler – Department of Nuclear Medicine, University Medical Center Bonn, Bonn, Germany

Thomas J. Ettrich – Department of Internal Medicine I, Ulm University Hospital, Ulm, Germany

Helmut Friess – Department of Surgery, Klinikum rechts der Isar, Technical University Munich,

Munich, Germany

Emmanouil Fokas – Department of Radiotherapy and Oncology, University Hospital Frankfurt,

Goethe-University Frankfurt, Frankfurt, Germany

Frank Griesinger – University Hospital Internal Medicine-Oncology, Pius Hospital, Universiy Medi-

cine Oldenburg, Oldenburg, Germany

Axel Heidenreich – Department of Urology, University Hospital Cologne, University of Cologne,

Cologne, Germany

Member of Deutsche Krebsgesellschaft e.V.

S. Eckhardt (1978–1989), R. Gross (1978–1980), J.H. Holzner (1978–1990), N. Jaeger (1978–1980),

K. Munk (1978–1980), G.P. Murphy 1978–1980), J.P. Obrecht (1978–1979), A. Stacher (1978–1980),

St. Tanneberger (1978–1980), W. Wilmanns (1978–1980), H. Wrba (1978–1980), G.A. Nagel (1981–1988),

W. Queißer (1989–2002), W. Huber (1992–1998), H.-J. Schmoll (2002–2012), M. Hallek (2011–2020)

Oncology

Research and

Treatment

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Marcus Hentrich – Department of Hematology and Oncology, Red Cross Hospital Munich, Munich,

Germany

Philipp Ivanyi – Department of Hematology, Hemostaseology, Oncology and Stem Cell Transplan-

tation, Medical School Hannover, Hannover Germany

Wolfgang Janni – Department of Obstetrics and Gynecology, University of Ulm, Ulm, Germany

Jens Peter Klussmann – Department of Otolaryngology (Head and Neck Surgery), University Hospi-

tal Cologne, University of Cologne, Cologne, Germany

Matthias Kroiss – Department of Medicine IV, University Hospital, LMU Munich, Munich, Germany

Hauke Lang – Department of General, Visceral and Transplant Surgery, University Medical Center,

Johannes Gutenberg University Mainz, Mainz, Germany

Anne Letsch – Department of Medicine II, Hematology and Oncology, University Hospital

Schleswig-Holstein, Kiel, Germany

Lars Lindner – Department of Medicine III, University Hospital, LMU Munich, Munich, Germany

Wolfram Malter – Department of Obstetrics and Gynecology, Cologne University Hospital, Univer-

sity of Cologne, Cologne, Germany

Volkmar Müller – Department of Gynecology, University Medical Center Hamburg-Eppendorf,

Hamburg, Germany

Christian Pallasch – Department I of Internal Medicine and Center of Integrated Oncology, University

Hospital Cologne, University of Cologne, Cologne, Germany

Peter Reichardt – Department of Oncology and Palliative Care, Sarcoma Center Berlin-Branden-

burg, Helios Klinikum Berlin-Buch, Berlin, Germany

Guido Reifenberger – Department of Neuropathology, Medical Faculty, Heinrich Heine University,

Düsseldorf, Germany

Anke Reinacher-Schick – Department of Hematology, Oncology and Palliative Care, Ruhr-Universi-

ty Bochum, Bochum, Germany

Friedemann Schad – Department of Interdisciplinary Oncology and Palliate Medicine, Gemein-

schaftskrankenhaus Havelhöhe, Berlin, Germany

Marc Schlaeppi – Center for Integrative Medicine, Cantonal Hospital St Gallen, St Gallen, Switzer-

land

Marcus Schmidt – Department of Obstetrics and Gynecology, University Medical Center Mainz,

Johannes Gutenberg University Mainz, Mainz, Germany

Matthias Theobald – Third Department of Medicine (Hematology, Oncology, and Pneumology),

University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany

Michael Thomas – Department of Thoracic Oncology, Translational Lung Research Center Heidel-

berg, Thoraxklinik at Heidelberg University Hospital, Heidelberg, Germany

Michael von Bergwelt – Department of Medicine III, University Hospital, LMU Munich, Munich,

Germany

Marie von Lilienfeld-Toal – Institute of Diversity Medicine, c/o Deanery of the Medical Faculty,

Bochum, Germany

Ulrich Wedding – Department of Medicine II, University Hospital Jena, Jena, Germany

Editorial Board

Peter Albers – Department of Urology, Düsseldorf University Hospital, Düsseldorf, Germany

Dirk Arnold – Department of Oncology, Asklepios Tumorzentrum Hamburg, AK Altona, Hamburg,

Germany

Akin Atmaca – Department of Oncology and Hematology, Krankenhaus Nordwest, UCT-University

Cancer Center, Frankfurt/M., Germany

Claudia Bausewein – Department of Palliative Medicine, University Hospital, LMU Munich, Munich,

Germany

Dirk Beutner – Department of Otorhinolaryngology, Head and Neck Surgery, University of Göt-

tingen, Göttingen, Germany

Peter Brossart – Department of Internal Medicine III, University Hospital Bonn, Bonn, Germany

(Continued on next page)

(Continued)

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Andrea D’Aviero – Radiation Oncology, Mater Olbia Hospital, Olbia, Italy

Edgar Dippel – Department of Dermatology, Klinikum Ludwigshafen, Skin Cancer Center Rhein-

pfalz, Ludwigshafen, Germany

Alexander Drzezga – Department of Nuclear Medicine, University of Cologne, Cologne, Germany

Andreas Engert – Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn

Cologne Düsseldorf and German CLL Study Group, University of Cologne, Cologne, Germany

Franziska Geiser – Department of Psychosomatic Medicine and Psychotherapy, University Hospital

Bonn, Bonn, Germany

Ulrich Herrlinger – Division of Clinical Neurooncology, Department of Neurology, Medical Center,

University of Bonn, Bonn, Germany

Andreas Hochhaus – Department of Hematology/Oncology, Clinic of Internal Medicine II, Jena

University Hospital, Friedrich Schiller University Jena, Jena, Germany

Friedemann Honecker – Tumor and Breast Center ZeTuP St. Gallen, St. Gallen, Switzerland

Heinz Kölbl – Department of Obstetrics and Gynecology, Comprehensive Cancer Center, Medical

University of Vienna, Vienna, Austria

Walther Kuhn – Department of Gynecology and Obstetrics, Donau-Isar-Klinikum, Deggendorf,

Germany

Thorsten Langer – Pediatric Oncology and Hematology, University Hospital for Children and Ado-

lescents, University Hospital Schleswig-Holstein, Lübeck, Germany

Peter Mallmann – Department of Obstetrics and Gynecology, Cologne University Hospital, Univer-

sity of Cologne, Cologne, Germany

Anja Mehnert – Department of Medical Psychology and Medical Sociology, University Medical

Center Leipzig, Leipzig, Germany

Holger Moch – Department of Pathology and Molecular Pathology, University Hospital Zurich,

Zurich, Switzerland

Anke Reinacher-Schick – Department of Hematology, Oncology and Palliative Care, Ruhr-

University Bochum, Bochum, Germany

Ingo B. Runnebaum – Department of Gynecology and Reproductive Medicine, Jena University

Hospital, Friedrich-Schiller-University Jena, Jena, Germany

Hans-Ulrich Schildhaus – Institute of Pathology Nordhessen, Kassel, Germany

Patrick Schöﬀski – Department of General Medical Oncology, University Hospitals Leuven, Leuven

Cancer Institute, Leuven, Belgium

Florian Schütz – Department of Gynecology and Obstetrics, Diakonissen-Stiftungs-Krankenhaus

Speyer, Speyer, Germany

Jalid Sehouli – Department of Gynecology with Center for Oncological Surgery, Charité – Univer-

sitätsmedizin Berlin, Berlin, Germany

Nicole Skoetz – Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn

Cologne Düsseldorf and German CLL Study Group, University of Cologne, Cologne, Germany

Christine Spitzweg – Department of Internal Medicine IV, University Hospital of Munich, LMU

Munich, Munich, Germany

Imke Strohscheer – Deutsche Rentenversicherung Nord, Lübeck, Germany

Selma Ugurel – Department of Dermatology, University Hospital Essen, University Duisburg-Essen,

Essen, Germany

Raymond Voltz – Department of Palliative Medicine, University Hospital Cologne, University of

Cologne, Cologne, Germany

Michael Weller – Department of Neurology, University Hospital and University of Zurich, Zurich,

Switzerland

Jens Werner – Department of General, Visceral, and Transplant Surgery, LMU Munich, Munich,

Germany

Thomas Zander – Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn

Cologne Düsseldorf and German CLL Study Group, University of Cologne, Cologne, Germany

Oliver Zivanovic – Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer

Center, New York, NY, USA

(Continued)

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Journal Information

Aims and Scope

Oncology Research and Treatment offers an interdisciplinary forum for cancer research and

treatment. Peer-reviewed original and review articles cover a wide range of aspects in med-

ical hematology and oncology, surgical, neurosurgical, gynecological, pediatric and uro-

logical oncology, oral and maxillofacial surgery, dermatological oncology, diagnostics, ra-

diation oncology, psychological care, pathology, clinical-translational oncology, biometry,

and oncological rehabilitation. Continuous medical education and clinical news form a fur-

ther focus. Compact and current, Oncology Research and Treatment keeps both clinicians and

researchers up to date.

Oncology Research and Treatment is addressed to clinicians and practitioners working and

researching in the field of hematology and oncology.

ISSN Print Edition: 2296–5270

ISSN Online Edition: 2296–5262

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Onkologie-Studie 2018

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36. Deutscher Krebskongress

Fortschritt gemeinsam gestalten

21.–24. Februar 2024, Berlin

ABSTRACTS

Herausgeber

Reinhard Büttner, Köln

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Disclosure Statement Guest Editor

The Editor declares that he has no conﬂict of interest.

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Kongresspräsident

Abstract-Gutachter

Reinhard Büttner, Köln

Marius Adler, Göttingen; Bernd Alt-Epping, Heidelberg; Udo Altmann, Essen; Philipp

Arndt, Essen; Dirk Arnold, Hamburg; Beyhan Ataseven, Detmold; Ambros Beer, Ulm;

Meinrad Beer, Ulm; Corinna Bergelt, Greifswald; Dirk Böhmer, Berlin; Servet Bölükbas,

Essen; Thomas Brabletz, Erlangen; Wolfgang Brückl, Nürnberg; Judith Büntzel,

Göttingen; Reinhard Büttner, Köln; Reiner Caspari, Bad Neuenahr-Ahrweiler; Carsten

Denkert, Marburg; Andreas Dinkel, München; Uta Dirksen, Essen; Hans Roland Dürr,

München; Angelika Eggert, Berlin; Rainer Engers, Neuss; Annette Freidank, Fulda; Peter

Friedl, Nijmegen; Jörn Gattermann, Bremen; Florian Gebauer, Wuppertal; Christina

Gerlach, Heidelberg; Roland Goldbrunner, Köln; Ralf Gutzmer, Minden; Boris Hadaschik,

Essen; Ken Herrmann, Essen; Jochen Hess, Heidelberg; Andreas Hochhaus, Jena; Stefan

Höcht, Potsdam; Jens Hoﬀmann, Berlin; Wilfried Hoﬀmann, Badenweiler; Wolfgang

Hoﬀmann, Greifswald; Uta Höpken, Berlin; Rudolf M. Huber, München; Gerdt Hübner,

Oldenburg; Jutta Hübner, Jena; Ulrich Jaehde, Bonn; Jens Jakob, Mannheim; Klaus-Peter

Janssen, München; Ingolf Juhasz-Böss, Freiburg; Lukas Käsmann, München; Alexander

Katalinic, Lübeck; Christian Keinki, Berlin; Ludwig Kiesel, Münster; Alexander Kleger,

Ulm; Aris Koryllos, Düsseldorf; Matthias Kroiss, München; Cornelia Kropf-Sanchen,

Ulm; Stephan Lang, Essen; Cornelia Mauch, Köln; Ilektra-Antonia Mavroeidi, Essen;

Ursula Nestle, Mönchengladbach; Jan Philipp Novotny, Heidelberg; Thorsten Persigehl,

Köln; Joachim Pfannschmidt, Berlin; David Pﬁster, Köln; Michael Platten, Heidelberg;

Alexander Quaas, Köln; Michael Quante, Freiburg; Christian Reinhardt, Essen; Margitta

Retz, München; Oliver Rick, Bad Wildungen; Stefan Rieken, Göttingen; Felix Carl Saalfeld,

Dresden; Thorsten Schmidt, Lübeck; Tilman Schöning, Heidelberg; Hubert Serve,

Frankfurt; Sebastian Stintzing, Berlin; Herwig Strik, Bamberg; Tim Vilz, Bonn; Meike

Vogler, Frankfurt; Petra Voiss, Essen; Beate Volkmer, Buxtehude; Bastian von Tresckow,

Essen; Thorsten Walles, Magdeburg; Markus Wallwiener, Heidelberg; Wolfgang Walther,

Berlin; Daniel Wecht, Marburg; Ulrich Wedding, Jena; Lisa Wiesmüller, Ulm; Peter J. Wild,

Frankfurt; Jürgen Wolf, Köln; Barbara Wollenberg, München; Rachel Würstlein, München;

Tanja Zimmermann, Hannover; Daniel Zips, Berlin; Johannes Zuber, Wien

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Inhalt

Best-of-Abstract-Vortrag

Articial Intelligence in Cancer Care and Diagnostics

Biomarker

Breast Cancer

Central Nervous System

Gastrointestinal Cancer: Colorectal

Gastrointestinal Cancer: other than colorectal

Genitourinary Cancer including Prostate Cancer

Gynecologic Cancer

Head and Neck Cancer

Health Economy/Public Health

Hematooncology including Bone marrow transplantation, Lymphoma,

Plasmocytoma

Imaging

Novel Therapeutics: Targeted Therapies, Immunotherapies, Cellular Therapies

Onkologische Pege

Psychooncology

Sarcoma

Supportive Care

Thoracic Cancer

Poster

Articial Intelligence in Cancer Care and Diagnostics

Biomarker

Breast Cancer

Central Nervous System

Endocrine Tumors

Epidemiology

Epigenetic and Metabolomic Targets

Gastrointestinal Cancer: Colorectal

Gastrointestinal Cancer: other than colorectal

Genitourinary Cancer including Prostate Cancer

Geriatric Oncology

Gynecologic Cancer

Head and Neck Cancer

Health Economy/Public Health 107

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Inhalt

112

124

136

140

141

150

151

155

168

171

177

180

192

197

203

206

217

218

Hematooncology including Bone marrow transplantation, Lymphoma,

Plasmocytoma

Imaging

Lung Cancer

Molecular Pathology

Novel Therapeutics: Clinical Trials

Novel Therapeutics: Targeted Therapies, Immunotherapies, Cellular Therapies

Oncological Pharmacy

Onkologische Pege

Other Topics

Paediatric Cancer

Palliative Care

Primary and Secondary Prevention

Psychooncology

Radiation

Rehabilitation, Sports Medicine, and Long-term Burden in Cancer Survivors

Sarcoma

Skin Cancer including Melanoma

Supportive Care

Surgical Oncology including Robotics

Thoracic Cancer

Translational Oncology 219

Late-Breaking Abstracts

Best-of-Abstract-Vortrag

Breast Cancer 227

Endocrine Tumors 228

Gastrointestinal Cancer: other than colorectal 228

Genitourinary Cancer including Prostate Cancer 230

Hematooncology including Bone marrow transplantation, Lymphoma,

Plasmocytoma 230

Lung Cancer 231

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Inhalt

232

233

234

235

236

237

238

239

240

241

242

243

247

248

249

250

252

253

254

257

260

261

Poster

Articial Intelligence in Cancer Care and Diagnostics

Biomarker

Breast Cancer

Cancer of Unknown Primary (CUP)

Central Nervous System

Endocrine Tumors

Epidemiology

Gastrointestinal Cancer: Colorectal

Gastrointestinal Cancer: other than colorectal

Genitourinary Cancer including Prostate Cancer

Gynecologic Cancer

Head and Neck Cancer

Health Economy/Public Health

Hematooncology including Bone marrow transplantation, Lymphoma,

Plasmocytoma

Lung Cancer

Molecular Pathology

Novel Therapeutics: Targeted Therapies, Immunotherapies, Cellular Therapies

Onkologische Pege

Other Topics

Primary and Secondary Prevention

Psychooncology

Radiation

Rehabilitation, Sports Medicine, and Long-term Burden in Cancer Survivors

Sarcoma

Skin Cancer including Melanoma

Supportive Care

Surgical Oncology including Robotics

Thoracic Cancer

Translational Oncology

Autorenindex 262

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Abstracts

Best-of-Abstract-Vortrag

Articial Intelligence in Cancer Care and

Diagnostics

158

Label-free Infrared Imaging for Cancer Diagnostics

in Computational Pathology

Frederik Großerüschkamp; Stephanie Schörner; Klaus Gerwert

Ruhr-Universität Bochum/Zentrum für Proteindiagnostik (PRODI), Deutschland

Background: Label-free infrared (IR) imaging allows the analysis of

unstained tissue slides. Morphology and molecular composition are

determined by spatially resolved IR spectra. By using articial intelligence

(AI), disease-specic information can thus be obtained. is has already

been successfully used for various cancers, e.g. colon (CC) and lung can-

cer (LC).1,2

Methods: Unstained cancer tissue slides were measured (avg. 30 min/

slide) and analyzed. Cancer regions were rst identied based on AI, e.g.

a convolutional neural network (CNN) CompSegNet for segmentation.

Subsequently, the lesions can be analyzed in more depth using further AI

models to identify molecular changes. Endpoints were always area under

receiver operating characteristic (AUROC) and area under precision

recall curve (AUPRC).

Result: In our most comprehensive study 547 patients (validation n=147)

with CC were analyzed to identify microsatellite instability (MSI). e

MSI classication reached an AUROC of 0.9 and AUPRC of 0.74 (sensi-

tivity 85%, specicity 84%).1 Further, we demonstrated detection down to

mutation status (TP53, EGFR, RAS) in LC adenocarcinomas (sensitivity

95%, specicity 95%, n=214, validation n=60).2

Discussion: MSI classication in CC reaches an AUROC of 0.9 and driver

mutations in LC can be identied. IR imaging achieves comparable results

to the current gold standard staining. Besides, it requires fewer samples

for training when compared to other AI approaches which could facilitate

the development of prognostic/predictive classiers in the setting of ran-

domized controlled trials.

Conclusion: Label-free IR imaging shows its potential for diagnos-

tics. Further larger studies are needed to bring it into translation. e

unstained tissue samples are still available aer analysis for further inves-

tigations. We expect our approach to be a broadly applicable diagnostic

tool in the future.

Indication of source:

1 Gerwert, K., Schörner, S. et al., Eur J Cancer, 2023, 182, 122–131.

2 Goertzen, N. et al., Am J Pathol, 2021, 191, 7, 1269–1280.

Disclosure Statement: e authors declare no conict of interest.

834

Automatic AI-based segmentation of renal tumors on clinical

routine CT data: a multicenter study

Sophie Bachanek; Paul Würzberg; Manuel Nietert; Lutz Trojan;

AnnemarieUhlig; Joachim Lotz; Johannes Uhlig

Universitätsmedizin Göttingen, Göttingen, Deutschland

Background: To develop an automatic segmentation algorithm and vis-

ualisation method for renal tumors using CT studies acquired in clinical

practice.

Methods: Renal tumor patients diagnosed between 2018 and 2021 were

retrospectively included. Patients aged <18years, and those with cystic or

inltrative renal tumors (i.e. lymphomas) were excluded. All renal tumors

were manually segmented by a GU-radiologist on all axial CT slices. A

convolutional neural network (UNET) was trained on a subset of manual

segmented CT-studies. Internal validation was performed on a subset of

20% of the training data. An external dataset (publicly available KITS-

2019 TCIA dataset) was used for independent model testing. e perfor-

mance of the UNETs predictions for renal tumor contours was compared

to manual segmentations and quantied by the DICE score.

Result: e training dataset contained n=639 patients (37% female;

median age 66y; median tumor diameter 47mm) with CT-studies from

more than 25 radiological centers with varying image quality. In the inter-

nal validation dataset, all renal tumors were at least partially identied by

the UNET (100% of renal tumors with DICE-Score > 0). e median DICE

score was 0.82-0.84. In the external testing dataset, a total of n=208/210

renal tumors (99%) were at least partially identied by our AI algorithm.

e renal tumor segmentation in the independent testing dataset yielded

a median DICE-Score=0.80. UNET segmentation predictions were vis-

ualized using color-coding and contour-lines to depict model and data

uncertainty. Additionally, UNET segmentation predictions were overlaid

on clinical CT images to provide visual feedback.

Discussion: Utilization of color-coding and contour-lines overlaid on

original CT-images provides an explainable approach to the UNETs pre-

dictions and might improve acceptance in clinical practice.

Conclusion: A UNET yields a robust automatic delineation of renal

tumors on CT-studies acquired in clinical routine.

Disclosure Statement: e authors declare no conict of interest.

839

Radiomics and machine learning for the assessment of

renal tumor histological subtypes on multiphase computed

tomography: a multicenter trial with independent testing

Sophie Bachanek1; Andreas Leha1; Philip Zeuschner2;

Alexander Maßmann3; Lutz Trojan1; Johannes Uhlig1; Joachim Lotz1;

Annemarie Uhlig1

1Universitätsmedizin Göttingen, Göttingen, Deutschland

2Universitätsklinikum des Saarlandes, Homburg, Deutschland

3Robert-Bosch-Klinik, Stuttgart, Deutschland

Background: To distinguish histological subtypes of renal tumors identi-

ed on multiphase computed tomography (CT) using radiomic features

and machine learning in a multicenter setting.

Oncol Res Treat 2024;47(suppl 1):7–283

DOI: 10.1159/000535363

karger@karger.com

www.karger.com/ort

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts8

Methods: Patients undergoing surgical resection and histopathological

assessment of renal tumors at two tertiary urological centers between 2012-

2022 were retrospectively included. Preoperative arterial and venous phase

CTs from multiple referring imaging centers were segmented and standard-

ized radiomic features extracted. Aer preprocessing and class imbalance, an

extreme gradient boosting tree-based (XGB) machine learning (ML) algo-

rithm was used to predict renal tumor subtypes using 10-fold cross validation,

assessed as multiclass AUC. ML algorithms were trained on data from one

center, and independently tested on data from the other center.

Result: e training cohort comprised n=297 patients (n=191 ccRCC,

n=40 pRCC, n=22 chRCC, n=28 oncocytomas, and n=16 AML), and

the testing cohort n=121 patients (n=68/n=20/n=4/n=26/n=3). e XGB

algorithm demonstrated a diagnostic performance of AUC=0.81/ 0.64/

0.8 for venous / arterial / combined contrast phase CT in the training

cohort, and AUC=0.75/ 0.67/ 0.75 in the independent validation cohort.

In pairwise comparisons, the lowest diagnostic accuracy was evident for

identication of oncocytomas (AUC=0.57-0.69), and the highest for iden-

tication of AMLs (AUC=0.9-0.94).

Discussion: For renal tumor subtype discrimination, venous phase CT

yields the most pertinent imaging information, without evident diagnos-

tic benet of an added arterial contrast phase. Among all renal tumors,

oncocytomas are hardest to dierentiate using CT.

Conclusion: Radiomic feature analyses acquired from clinical routine CT

yield robust results for renal tumor assessment.

Disclosure Statement: e authors declare no conict of interest.

Biomarker

622

Enhancing Personalized Cancer Therapy through

Comprehensive Tumor Proling: Real-World Insights from

Metastatic Patients

Dörthe Scharin-Nabe1; David Reismann2; Stefan Schuster2;

Rudolf Voigtmann1

1Hämatologisch-onkologische Praxis, Bochum, Deutschland

2Datar Cancer Genetics Europe GmbH, Bayreuth, Deutschland

Background: Optimization of cancer therapy using predictive and prog-

nostic biomarkers has advanced, yet their integration into practice remains

complex. Analyzing DNA alterations yields benets in a subset of patients,

leaving gaps in consistent outcomes. Comprehensive tumor proling could

enhance treatment ecacy by identifying actionable tumor characteristics.

Methods: We studied 42 patients with progressive metastatic solid

tumors. We assessed tissue and blood for holistic proling, encompass-

ing genetics, expression, IHC, pharmacogenomics, and chemosensitivity.

Additional data (imaging, ECOG status, etc.) collected over four years

compared progression-free survival (PFS2) aer individualized therapy

with previous treatment (PFS1).

Result: Comprehensive tumor proling led to improved PFS in 66% of

patients, surpassing outcomes of previous treatments (PFS2/PFS1 > 1).

Notably, a subset of patients (29%) demonstrated a twofold increase in

PFS. e median PFS2/PFS1 ratio of 1.25 underscored the clinical signi-

cance of this approach. Univariate analysis unveiled two adverse prognos-

tic scenarios: higher count of oncogenes and presence of p53 mutations.

Interestingly, individualized treatment showed no discernible impact on

ECOG status.

Discussion: Applying personalized treatments is still challenging today

also because initial basket trials failed. With advancing technologies, our

understanding of the heterogeneous tumor biology increases further,

and we understand better how to tailor treatment. Still, for broad clinical

application and acceptance these approaches must become widely availa-

ble and comparable. Finally, the challenges will be to inherit holistic diag-

nostics in guidelines to optimize treatment in the future.

Conclusion: Conuence of proling marks signicant progress. Moving

beyond gene targets, broader considerations lead to informed treat-

ment-strategies. Our study underscores this potential in rening real-

world outcomes and encourages exploration to rethink and rene

personalized cancer therapy.

Disclosure Statement: e authors declare the following: D.R. and S.S. are

employed at Datar Cancer Genetics Europe GmbH, Bayreuth, Germany, focusing

on new diagnostic solutions in oncology. e remaining authors declare no

conict of interest.

Breast Cancer

423

Impact of Dose Reductions on Ecacy of Adjuvant

Abemaciclib for Patients with High Risk Early Breast Cancer

(EBC): Analyses from the monarchE Study

Matthias Zaiss1; Joyce O’shaughnessy2; Irfan Cicin3; Laura Testa4; Sara M.

Tolaney5; Jens Huober6,7; Valentina Guarneri8,9; Stephen R.D. Johnston10;

Miguel Martin11; Priya Rastogi12; Nadia Harbeck13; Hope Rugo14; Ran Wei15;

Valerie Andre15; Ashwin Shahir16; Matthew P. Goetz17

1Praxis für interdisziplinäre Onkologie, Freiburg, Deutschland

2Baylor University Medical Center, Texas Oncology, US Oncology, Dallas, USA

3Trakya University Faculty of Medicine, Edirne, Türkei

4Instituto D’Or de Pesquisa e Ensino (IDOR), Sao Paulo, Brasilien

5Dana-Farber Cancer Institute, Boston, USA

6Cantonal Hospital St. Gallen, Breast Centre St. Gallen, St. Gallen, Schweiz

7University of Ulm, Dept of Gynecology, Ulm, Deutschland

8Department of Surgery, Oncology and Gastroenterology, University of Padova,

Padua, Italien

9Istituto Oncologico Veneto IRCCS, Padua, Italien

10Royal Marsden NHS Foundation Trust, London, United Kingdom

11Hospital General Universitario Gregorio Marañon, Universidad Complutense,

CIBERONC, GEICAM, Madrid, Spanien

12University of Pittsburgh/UPMC, NSABP Foundation, Pittsburgh, USA

13Breast Centre, Department of Gynaecology and Obstetrics, Comprehensive

Cancer Centre München, LMU University Hospital, München, Deutschland

14University of California San Francisco Hellen Diller Family Comprehensive

Cancer Center, San Francisco, USA

15Eli Lilly and Company, Indianapolis, USA

16Loxo@Lilly, Indianapolis, USA

17Department of Oncology, Mayo Clinic, Rochester, USA

Background: Abemaciclib is approved as adjuvant therapy for HR+,

HER2−, high-risk early breast cancer (EBC) based on clinically signi-

cant improvements in invasive disease-free survival (IDFS) and distant

relapse-free survival (DRFS), which were maintained and deepened aer

the 2-year treatment period was completed. In monarchE, 44% of patients

required dose reductions of abemaciclib to proactively manage adverse

events. In abemaciclib MBC trials, similar rates of dose reductions did not

compromise PFS. Here, we present the exploratory analyses to investigate

the impact of dose reductions on ecacy in monarchE.

Methods: In monarchE, up to 2 abemaciclib dose reductions were permit-

ted prior to discontinuation. Pts treated with abemaciclib were classied

into 3 equal-sized subgroups according to their abemaciclib relative dose

intensity (RDI), and IDFS rates were estimated within each subgroup. A

time-dependent Cox proportional hazard (PH) model was also imple-

mented to assess the impact of dose levels over time on IDFS.

Result: Among the 2791 pts treated with abemaciclib, 832 (30%) had 1

and 389 (14%) had 2 dose reductions. Patients ≥65 years old, or those

with ≥4 pre-existing co-morbidities were more likely to have dose reduc-

tions. Across the 3 RDI groups (≤66% vs 66%-93% vs ≥93%), 4-year IDFS

rates were generally consistent (87.1% vs 86.4% vs 83.7% from the lowest

RDI group to the highest). According to the time-dependent model, the

eect of abemaciclib is similar when staying at the full 150-mg dose com-

pared to being dose reduced to either 100 mg or 50 mg (HR=0.905; 95%

CI=0.727, 1.125).

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 9

Discussion: Consistent with observations in the metastatic setting, the

ecacy of adjuvant abemaciclib in monarchE was not compromised by

dose reductions.

Conclusion: Dose reductions should be considered as a safe and eective

way to manage toxicity and retain patients on treatment, in order to main-

tain benet from adjuvant abemaciclib in combination with endocrine

therapy.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

710

Timing of neoadjuvant or adjuvant therapy in patients with

early triple negative breast cancer

Maria Eleni Hatzipanagiotou1; Miriam Pigerl1; Michael Gerken2;

Sophie Raepple1; Verena Zeltner1; Madeleine Hetterich1; Peter Ugocsai1;

Elisabeth C. Inwald1; Monika Klinkhammer-Schalke3; Stephan Seitz1;

Olaf Ortmann1

1Department of Gynecology and Obstetrics, University Medical Centre

Regensburg, Regensburg, Deutschland

2Bavarian Cancer Registry, Regional Centre Regensburg, Bavarian Health and

Food Safety Authority, Regensburg, Deutschland

3Tumor Center - Centre for Quality Management and Health Services Research,

University of Regensburg, Regensburg, Deutschland

Background: To clarify, whether timing of systemic therapy has an impact

on survival in patients with early TNBC.

Methods: Data from a large population-based regional cancer registry

covering 2.2 million people was used for evaluation, including women

with diagnoses of TNBC between 2010 and 2018. Patients were catego-

rized into subgroups according to the interval from TNBC pathologic

diagnosis to the date of rst administration of NACT (TTNC) or accord-

ing to the interval from primary surgery to the date of rst administration

of adjuvant chemotherapy (TTAC). Univariable analyses of survival rates

were conducted using the Kaplan-Meier method.

Result: e nal study cohort included 732 patients with early TNBC,

of whom 43.6% were treated with NACT and 40.3% with adjuvant

chemotherapy.

Timing of NACT

• 270 patients with TNBC treated with NACT had a valid TTNC. Median

follow up was 3.5 years. Patients with TTNC ≤14, ≤42, >42, and >56

days had estimated mean OS of 8.4, 6.9, 4.6, and 3.3 years. Patients

with a TTNC ≤14 days were more likely to survive than patients with a

TTNC ≥ 56 days (p= 0.054). Signicance was barely not reached in the

group of NACT.

Timing of adjuvant chemotherapy

• 245 patients with TNBC treated with adjuvant chemotherapy had a

valid TTAC. Treatment given within 22-28 days aer surgery led to

the best outcome with a mean OS of 10.2 years, while patients who

started adjuvant chemotherapy aer 6 weeks had a lower median OS of

6.9 years. Patients who received therapy aer 22-28 days demonstrated

signicantly better survival compared to those who received therapy

aer more than 43 days (p=0.033).

Discussion: e results in this study indicate that there are critical time

intervals for initiation of systemic therapy in patients with early TNBC,

with reduced OS if NACT is applied later than 42 days aer diagnosis or if

adjuvant chemotherapy is applied later than 42 days aer surgery.

Conclusion: We recommend not to exceed the 6-week interval until the

initiation of systemic therapy in patients with early TNBC.

Disclosure Statement: e authors declare no conict of interest.

Central Nervous System

368

Validation of a Methylation-based Signature for

Subventricular Zone Involvement in Glioblastoma

Felix Ehret1; Oliver Zühlke1; Leonille Schweizer2; Johannes Kahn3;

Siyer Roohani1; Christoph Csapo-Schmidt2; David Capper 4;

Sebastian Adeberg5; Amir Abdollahi6; Daniel Zips1; Maximilian Knoll6;

David Kaul1

1Charité - Universitätsmedizin Berlin, Klinik für Radioonkologie und

Strahlentherapie, Berlin, Deutschland

2Universitätsklinik Frankfurt Main, Neurologisches Institut, Frankfurt,

Deutschland

3Charité - Universitätsmedizin Berlin, Institut für Neuroradiologie, Berlin,

Deutschland

4Klinik für Radioonkologie und Strahlentherapie, Institut für Neuropathologie,

Berlin, Deutschland

5Universitätsklinik Marburg, Klinik für Radioonkologie, Marburg, Deutschland

6DKFZ, Heidelberg, Deutschland

Background: Glioblastomas (GBM) with subventricular zone (SVZ) con-

tact have been associated with a specic epigenetic ngerprint. Here, we aim

to validate a reported bulk methylation signature to determine SVZ contact.

Methods: Illumina Human EPIC methylation array analysis was per-

formed on IDHwt GBM patients, the v11b4 classier was used to assure

the inclusion of only RTK I, II, and MES subtypes. Methylation-based

assignment (SVZM+/-) was performed using hierarchical cluster analysis.

Preoperative MRI (T1ce, T2) was independently reviewed for SVZ con-

tact by three experienced readers, two neuroradiologists, and one radia-

tion oncologist. e prognostic value of SVZ/SVZM was evaluated with

Cox-PH models.

Result: Sixty-ve samples were classied as RTK I, II, and MES. Full

T1ce MR-based rater consensus was observed in 54 cases, which were

retained for further analysis. Epigenetic SVZM classication and SVZ

were strongly associated (OR: 15.0, 95% CI: 1.8-711.5, p=0.003). irteen

of fourteen dierential CpGs on whole EPIC arrays (SVZM+ vs. SVZM-,

Bonferroni adjusted p<0.05) were located sequentially in the previously

described dierentially methylated LRBA/MAB21L2 locus. SVZ+ tumors

were linked to shorter OS (HR: 3.80 [1.23-11.75], p=0.03), as was SVZM+

at earlier time points (time-dependency of SVZM, p<0.05). Considering

the SVZ consensus as the ground truth, SVZM classication yields a sen-

sitivity of 96.6%, specicity of 36.0%, positive predictive value (PPV) of

63.6%, and negative predictive value (NPV) of 90.0%.

Discussion: Herein, we validated the epigenetic signature in GBM located

in the vicinity of the SVZ to highlight the importance of methylation of

a part of the MAB21L2/LRBA gene locus. Whether SVZM can replace

MRI-based SVZ assignment as a prognostic and diagnostic tool will

require prospective studies with larger and more homogeneous cohorts.

Conclusion: A DNA methylation-based SVZ signature could become a

valuable tool in the molecular and spatial characterization of GBM.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts10

Gastrointestinal Cancer: Colorectal

694

Lipid metabolism as critical link between gut microbiota

andcolorectal cancer

Florian Jokisch1; Anna Sichler1; Sven Hermeling2;

Josef Ecker2; Klaus-Peter Janssen1

1Klinikum rechts der Isar der Technischen Universität München, München,

Deutschland

2Technische Universität München, München, Deutschland

Background: Deregulated lipid metabolism is a hallmark of cancer cells,

yet its causal contribution to tumor initiation and progression, as well as

the functional connection with the gut microbiota and its metabolites is

largely unclear.

Methods: To address these open questions, mouse models (APC1638N/

APCmin) are considered under germ-free and SPF conditions, in which

features of lipid metabolism in human CRC are preserved. Tissue samples

are analyzed on histology and molecular level. Colon content will be used

for shallow metagenomic sequencing to monitor gut microbial composi-

tion. Patient-derived organoids, as well as clinical patient samples (three

independent cohorts, n=150) will be analyzed. MS-based lipidomics anal-

ysis will be carried out in cooperation with partners at TUM.

Result: Our group has already shown that the gut microbiota promotes

host lipid synthesis in the regenerating liver by providing SCFA, and they

limit intestinal lipid absorption. In fact, a deregulated lipid signature was

found in human CRC tissue and levels of dietary-derived PUFA in blood,

liver and intestine were clearly associated with the presence of gut micro-

biota. Moreover, we showed that SCD1 was positively regulated by gut

microbiota, signicantly increased in human CRC, and negatively asso-

ciated with prognosis.

Discussion: Preliminary results gathered evidence that the gut microbi-

ome interacts with the host cancer cell lipid metabolism at multiple and

non-redundant layers. Lipid metabolism is altered and contributes to

cancer formation in human CRC and cancer mouse models. SCD1 seems

to play a functional, tumor-promoting role in cancer cells and is causally

regulated by the microbiota.

Conclusion: To further allow new insights into the triad “Gut Microbiota

- Lipid Metabolism – CRC”, details on how gut microbiota causally impact

cancer cell lipid metabolism needs to be revealed. We aim to tackle an

unresolved, timely and clinically relevant scientic question in the eld of

molecular cancer and microbiome research.

Disclosure Statement: e authors declare no conict of interest.

726

HER receptor family synergism in the context of colorectal

cancer (CRC) based on new genetic mouse models

Laura Geyer1; Maik Dahlho 2; Klaus-Peter Janssen1

1Klinikum rechts der Isar der Technischen Universität München (TUM),

Department of Surgery, München, Deutschland

2Institut für In-vivo und In-vitro-Modelle/ Veterinärmedizinische Universität

Wien, Department für biomedizinische Wissenschaften, Wien, Österreich

Background: Epidermal growth factor (EGF) signaling is important for

the initiation, progression, and metastasis of cancer, mediated by the

HER/ERBB receptor family. Intratumoral overexpression of HER4 cor-

relates with bad prognosis in colorectal carcinoma (CRC), yet its func-

tion and interplay with other family members like EGFR, remains poorly

understood.

Methods: We established an intestinal epithelial cell specic deletion

(ΔIEC) of either Her4 or Egfr, or compound deletion in a tumor prone

mouse model (Apcmin/+). Tumor phenotypes and tissue was analyzed on

histological and molecular level. Furthermore, 3D organoid cultures from

tumor and intestinal tissues were generated. To extend the in vivo ndings,

HER-receptor CRISPR-Cas9 mediated knockouts were engineered in two

colorectal cancer cell lines.

Result: A signicant increase in tumor number and size was found in

compound mutant mice (Her4ΔIECxEgfrΔIECxApcmin/+) compared to single

knockout and Apcmin/+ controls. Of note, the respective single gene de-

ciencies had less of an eect on tumor initiation (number), but more on

tumor progression (size and anatomical localization) in the Apcmin/+ back-

ground. Moreover, organoids (normal and tumor) could be successfully

established from all genetic lines. Interestingly, tumor organoids from an

Egfr-decient background reproducibly failed to grow, which contrasts the

in vivo phenotype, in which loss of Egfr had no eect on tumor initiation.

Discussion: is unexpected phenotype seems to indicate a synergistic

eect due to the loss of both receptors (Her1 and Her4) which manifests

itself in earlier tumor initiation and progression. To further unravel this

receptor interplay on a deeper molecular level, RNA sequencing and pro-

teomic analysis of tissue and organoid samples will be conducted.

Conclusion: Analysis of the HER4-EGFR interplay may provide import-

ant insights regarding therapeutic strategies for patients with CRC, espe-

cially in cases of anti-EGFR therapy resistance.

Disclosure Statement: e authors declare no conict of interest.

Gastrointestinal Cancer: other than colorectal

273

Adjuvant nivolumab (NIVO) vs placebo (PBO) in resected

esophageal or gastroesophageal junction cancer (EC/GEJC)

following neoadjuvant chemoradiotherapy (CRT): rst report

of comprehensive biomarker analyses from CheckMate 577

Markus Möhler1; Ronan J. Kelly2; Jaer A. Ajani3; Jin Yao4; Jaroslaw

Kuzdzal5; Thomas Zander6; Eric Van Cutsem7; Guillaume Piessen8;

Guillermo Mendez9; Josephine Feliciano10; Satoru Motoyama11;

Astrid Lièvre12; Hope Uronis13; Elena Elimova14; Cecile Grootscholten15;

Karen Geboes16; Yingsi Yang4; Jenny Zhang4; Ruslan Novosiadly4;

James M. Cleary17; Ming Lei4

1Johannes-Gutenberg University Clinic, Mainz, Deutschland

2The Charles A. Sammons Cancer Center at Baylor University Medical Center,

Dallas, TX, USA

3University of Texas MD Anderson Cancer Center, Houston, TX, USA

4Bristol Myers Squibb, Princeton, NJ, USA

5Jagiellonian University, John Paul II Hospital, Krakow, Polen

6University of Cologne, Department of Internal Medicine, Center for Integrated

Oncology Aachen Bonn Cologne Düesseldorf, Gastrointestinal Cancer Group

Cologne (GCGC), Cologne, Deutschland

7University Hospitals Gasthuisberg, Leuven and KU Leuven, Leuven, Belgien

8University of Lille, Claude Huriez University Hospital, Lille, Frankreich

9Fundacion Favaloro, Buenos Aires, Argentinien

10Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore,

MD, USA

11Akita University Hospital, Akita, Japan

12CHU Pontchaillou, Rennes 1 University, Rennes, Frankreich

13Duke Cancer Institute, Durham, NC, USA

14Princess Margaret Cancer Centre, Toronto, ON, Canada

15Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam,

Netherlands Antilles

16UZ Gent, Gent, Belgien

17Dana Farber Cancer Institute, Boston, MA, USA

Background: Adjuvant NIVO demonstrated statistically signicant and

clinically meaningful improvement in disease-free survival (DFS) vs PBO

and an acceptable safety prole in resected EC/GEJC aer neoadjuvant

CRT in CheckMate 577. We present new exploratory biomarker analyses

from this study.

Methods: Whole exome sequencing (WES) of baseline post-CRT tumor

tissue and matching blood was performed to assess microsatellite insta-

bility (MSI), tumor mutational burden (TMB), and select gene muta-

tions. TMB-high (TMB-H) was dened as ≥ 199 mutations/exome. RNA

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 11

sequencing of baseline post-CRT tumor tissue was performed to assess

gene expression signatures (GES). GES subgroups were dened by signa-

ture score tertiles.

Results: 794 patients (pts) were randomized to NIVO or PBO, and the

DFS unstratied hazard ratio (HR) for NIVO vs PBO was 0.68 (95%

condence interval [CI], 0.56–0.83). 374 pts were WES-evaluable,

and the DFS unstratied HR was 0.81 (95% CI 0.60–1.08). Of these,

5 pts were MSI-high (MSI-H), and 13 pts were TMB-H. All MSI-H pts

had adenocarcinoma and were also TMB-H. DFS benet with NIVO

vs PBO was observed regardless of mutational status of select genes,

including PIK3CA, NOTCH1, CDKN2A, and ARID1A. 376 pts were

evaluable for GES, and the DFS unstratied HR was 0.84 (95% CI 0.63–

1.11). GES subgroups were categorized based on high (n = 126; 34%),

medium (n = 125; 33%) or low (n = 125; 33%) tertiles. Improved DFS

benet with NIVO vs PBO was observed in multiple GES subgroups,

including those with higher expression of inammatory and prolifer-

ation GES and lower expression of M2 macrophage, endothelial, and

broblast GES. First results from the dynamics of tumor programmed

death ligand 1 expression pre-/post-CRT and its association with e-

cacy will be presented.

Discussion: ese exploratory analyses indicate improved DFS benet

with NIVO vs PBO in multiple subgroups. e clinical utility of these bio-

markers should be validated in future trials.

Conclusions: ese results further support the benet of adjuvant NIVO

vs PBO in resected EC/GEJC aer neoadjuvant CRT.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

446

Organotypic slice cultures for ex vivo therapy response

prediction of pancreatic cancer

Benjamin Heckelmann1; Olga Lapshyn1; Daniel Fetzner1; Jannis Duhn1;

Anna Maxi Wandmacher2; Louisa Bolm1; Kim Honselmann1;

Oliver Schilling3; Maren Nicole Stillger3; Peter Bronsert3;

Christoph Röcken4; Susanne Sebens2; Tobias Keck1; Ulrich F. Wellner1;

Rüdiger Braun1

1University Clinic Schleswig-Holstein (UKSH) Campus Lübeck, Lübeck,

Deutschland

2Institute for Experimental Tumor Research, Christian-Albrechts-Universität zu

Kiel, Kiel, Deutschland

3Institute of Clinical Pathology, University of Freiburg, Freiburg, Deutschland

4Institute of Pathology, Christian-Albrechts-Universität zu Kiel, Kiel, Deutschland

Background: e poor prognosis of patients with pancreatic cancer

(PDAC) is also due to the limited response to chemotherapeutic agents.

We have established organotypic slice cultures (OTSCs) with the goal

of personalized therapy prediction. e model is characterized by rapid

establishment times and proximity to the original specimens.

Methods: Aer surgical resection and pathological examination, 20 fresh

PDAC tissue samples were cut with a Vibratome and cultivated for up

to 5 days. Standard therapy regimens gemcitabine (+ paclitaxel) and

FOLFIRINOX were added to the cultivation medium. erapy response

was measured by H&E and immunohistochemistry (IHC) staining for

tumor/stroma ratio, proliferation, apoptosis, and immune cell markers.

Digital pathology was used for semi-automatic quantication.

Result: From day 1 to day 5, no substantial structural changes were detected

in the untreated OTSCs. e immune cell populations remained stable for

at least 3 days. Treatments triggered heterogenous tissue reactions between

patients. OTSCs treated with gemcitabine + paclitaxel showed a higher

response rate in IHC stains for tumor cell count, proliferation, and apop-

tosis than OTSCs treated with gemcitabine. FOLFIRINOX-treated OTSCs

showed less proliferating tumor cells and higher rates of necrotic area than

gemcitabine + paclitaxel treated OTSCs. A correlation between treatment

response and survival is provided by the current follow-up of patients.

Discussion: Distinct ex vivo response of dierent patients to the same

treatment regimen indicates individual treatment sensibility between

patients due to intertumoral structural dierences in tissue architec-

ture. OTSCs complement other ex vivo models by enabling evaluation

of the tumor microenvironment, including the stroma and immune

compartment.

Conclusion: OTSCs preserve the multicellular tissue context of PDACs

ex vivo. Immediate establishment aer surgical resection enables rapid

individualized assessment of therapy response ex vivo.

Disclosure Statement: e authors declare no conict of interest.

Genitourinary Cancer including Prostate

Cancer

802

Modeling of an optimal PSA-based risk stratication at age 45

in the PROBASE trial

Agne Krilaviciute1; Maxime de Vrieze1; Axel Benner1; Jale Lakes2;

Markus A. Kuczyk3; Nina Harke3; Jürgen Peter Debus4; Stefan Körber4;

Jürgen Gschwend5; Kathleen Herkommer5; Glen Kristiansen6;

Gerald Antoch7; Lars Schimmöller8; Boris Hadaschik9; Christian Arsov10;

Petra Seibold1; Rudolf Kaaks1; Nikolaus Becker1; Peter Albers1,2

1Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Deutschland

2UKD - Universitätsklinikum Düsseldorf- Urologische Klinik, Düsseldorf,

Deutschland

3Medizinische Hochschule Hannover, Hannover, Deutschland

4Universitätsklinikum Heidelberg, Heidelberg, Deutschland

5Klinikum rechts der Isar der Technischen Universität München, München,

Deutschland

6UKB Universitätsklinikum Bonn, Bonn, Deutschland

7UKD - Institut für Diagnostische und Interventionelle Radiologie, Düsseldorf,

Deutschland

8Marien Hospital Herne, Herne, Deutschland

9Universitätsklinikum Essen, Essen, Deutschland

10Städtische Kliniken Mönchengladbach GmbH - Betriebsstätte Elisabeth-

Krankenhaus Rheydt Notfall-Ambulanz, Mönchengladbach, Deutschland

Background: Our purpose is to optimize PSA cut-os for risk-adapted

screening invitations. e cut-os used to determine screening intervals

in PROBASE are: PSA <1.5 ng/ml: 5 yrs (low risk); 1.5≤PSA<3: 2 yrs

(intermediate risk); PSA ≥3: MRI + biopsy (high risk).

Methods: PROBASE randomized 23,294 men aged 45 yrs to the immedi-

ate PCa screening arm. Initial risk groups for PCa were reanalyzed using

0.5-sized PSA subgroups (<0.5, ..., 2.5-2.99, ≥3 ng/ml) using data from

subsequent screening rounds at 5 yrs (initial low risk) and 6 yrs (initial

intermediate risk).

Result: Median PSA at 45 was 0.74 ng/ml (IQR 0.5-1.07). When analyzing

the 0.5-sized PSA subgroups, the percentage of men having PSA ≥3 ng/ml

within a median follow-up of 5.05 yrs (IQR 5.0-5.2) increased from 0.2%

(initial PSA <0.5) to 35% (initial PSA 2.5-2.99). Less than 0.1% of men

with initial PSA <1.5 ng/ml were diagnosed with PCa (0.04% of men with

PSA <1 ng/ml). In contrast, 12% of men with an initial PSA of 2.5-2.99

ng/ml had a PCa diagnosis within 6 yrs.

Discussion: In the future, men with low or very low baseline PSA at age 45

may be considered for a longer than 5 yrs screening intervals. is could

help to reduce unnecessary tests and diagnostic procedures triggered by

false-positive PSA elevations. Lowering the PSA threshold to 2.5 ng/ml

at which diagnostics for PCa is indicated might increase the detection of

prevalent cancers, but will also increase the need for additional testing,

e.g. by MRI, to maintain specicity. None of these strategy modications

addresses overdiagnosis and overtreatment though. Routine implemen-

tation of complementary approaches, such as active surveillance (AS)

instead of radical treatment for non-signicant PCa, may be required

before rolling out PSA testing to a population-based screening program.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts12

Conclusion: A baseline PSA <1.5 ng/ml at age 45 is a reliable predictor of

a low risk to develop PCa within 5 yrs. Modeling of an optimal PSA cut-o

for PCa diagnostics needs more data of subsequent screening rounds and

research on acceptance of AS in clinically non-signicant PCa.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

Gynecologic Cancer

716

Assessment of p53 in endometrial carcinoma biopsy and

corresponding hysterectomy specimens in a real world

setting: Which cases need molecular work-up?

Marie-Lisa Eich; Janna Siemanowski; Uta Drebber; Nicolaus Friedrich;

Sabine Merkelbach-Bruse; Birgid Schömig-Markiefka;

Alexander Quaas; Reinhard Büttner

Uniklinik Köln, Köln, Deutschland

Purpose: e WHO straties endometrial cancer into molecular sub-

groups with dierent prognosis leading to dierent treatment options.

One of these subgroups are tumors with abnormal p53. is study is the

rst, which examined p53 immunohistochemistry (IHC) on biopsy and

hysterectomy tissue and investigates the inter-observer variability among

pathologists in a real life clinical practice setting.

Methods: 98 endometrial biopsy and 86 hysterectomy cases from 101

patients were selected (in 83 patients both, biopsy and hysterectomy spec-

imen was available). Five pathologists with dierent levels of experience

independently evaluated p53 IHC staining in all cases. Furthermore, tar-

geted panel sequencing was successfully performed in 169/184 cases.

Results: In 14.3% to 23% of biopsy cases and 3.5% to 32.6% of resection

cases pathologists would perform molecular analysis for TP53 status inde-

pendently of their level of work experience.

When compared to the molecular TP53 status, pathologist’s individual

kappa values ranged from 0.61 to 1.0 for biopsy cases, considering only

cases, where pathologists relied on IHC evaluation without performing

molecular analysis. For resection cases, kappa values ranged from 0.83

to 1. In cases all pathologists agreed on IHC p53 status, molecular anal-

ysis showed the same results in 42/42 of evaluable wild type and 3/3 of

mutated biopsy cases and 42/42 of evaluable wild type and 5/5 mutated

resection cases.

Discussion: Although staining intensity varies considerably between

biopsy and hysterectomy specimens IHC p53 status showed a 100%

accordance with molecular TP53 status, when all ve pathologists agreed.

Moreover, cases scored by pathologists with experience in p53 evaluation

showed a high agreement with molecular status (kappa levels up to 1).

However, pathologists would have required molecular work-up in up to

1/3 of all cases.

Conclusion: IHC p53 can serve as a surrogate marker, if pathologists

received adequate training for evaluation. Molecular analysis should be

performed in all equivocal cases.

Disclosure Statement: e authors declare the following: Unternehmen der

Gesundheitswirtscha.

Head and Neck Cancer

332

Analysis of the tumor immune microenvironment in advanced

adenoid cystic carcinoma

Erika Zuljan1; Eric Blanc1; Benjamin von der Emde2; Iris Piwonski2;

Frederick Klauschen2; Ingeborg Tinhofer-Keilholz2; Andreas Mock3;

Peter Horak4; Ulrich Keller2; Konrad Klinghammer2; Stefan Fröhling4;

Sebastian Ochsenreither2; Ulrich Keilholz2; Dieter Beule1; Damian Rieke1

1Berlin Institute of Health (BIH), Berlin, Deutschland

2Charité, Berlin, Deutschland

3Ludwig-Maximilians-Universität München (LMU), München, Deutschland

4Nationales Centrum für Tumorerkrankungen – NCT, Heidelberg, Deutschland

Background: Adenoid cystic carcinoma (ACC) is a malignant tumor that

can arise from several anatomical sites, including the salivary glands. It is

characterized by high rates of recurrence/metastasis, an immune depleted

microenvironment and poor response to immunotherapy. e aim of this

study is to characterize the tumor immune microenvironment (TIM) in

advanced ACC in order to identify potential therapeutic targets.

Methods: Advanced ACC from the DKTK MASTER program were ana-

lysed using bulk RNA- (n=57), exome (n=27) and genome sequencing

(n=35). Tumor immune inltration was estimated based on GSVA scores

of published immune-cell signatures. e TMB was calculated based on

genome and exome data as number of non- synonymous mutations per

Mb. Both inammation and TMB were compared to TCGA and pub-

lished ACC data. Immunohistochemistry was used as validation.

Result: Immune inltration was signicantly lower in ACC than in most

tumors sequenced in the Cancer Genome Atlas (TCGA). e tumor muta-

tional burden (TMB) was also among the lowest (median: 0.83). No asso-

ciation was found between inammation and TMB or clinical parameters.

RNA-seq immune deconvolution found 3 clusters of immune- inltration

in ACC, with most ACC belonging to the least inamed cluster but iden-

tied an ACC subgroup with high inammation. e immune checkpoint

VTCN1 was found to be signicantly overexpressed in ACC, which was

conrmed by immunohistochemistry.

Discussion: ese data suggest that, although ACC have low inamma-

tion, a small subset of patients show an inamed TIM and might ben-

et from immune checkpoint inhibition. VTCN1 is highly expressed in

tumor cells and could represent a therapeutic target.

Conclusion: Biomarker-stratied immunotherapies should be further

investigated in ACC. A clinical trial of a VTCN1-directed therapy is

ongoing.

Disclosure Statement: e authors declare no conict of interest.

460

Analyses of eector and suppressive B cell populations in

head and neck tumor bearing mice

Michael Sonntag1; Simon Laban1; Marie-Nicole Theodoraki2;

Patrick Schuler1; Thomas Homann1; Cornelia Brunner1

1Department of Otorhinolaryngology, Head and Neck Surgery, Ulm,

Deutschland

2Department of Otorhinolaryngology, Head and Neck Surgery, München,

Deutschland

Background: Tumor-inltrating B cells signicantly aect tumor growth

and treatment ecacy. Diverse B cell subpopulations in the immune

system have a dual role, promoting and inhibiting tumor progression in

Head and Neck Squamous Cell Carcinoma (HNSCC).

Methods: We established an HNSCC murine model by injecting SCC-VII

cells into oral cavities. Aer 21 days, we isolated cells from blood, spleen,

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 13

lymph nodes and tumors, comparing them to healthy controls using ow

cytometry (FACS) and immunohistochemistry (IHC). Enzyme-linked

immunosorbent assays (ELISA) tracked immunoglobulin levels aer

tumor introduction.

Result: GL7+ CD95+ germinal center B cells and CD39+/CD73+ B cells

increased in tumors and spleens of carcinoma-bearing mice. IgM antibody

concentration in mouse serum continuously rose during the observation

period. IgG1, IgG2, and IgG3 levels increased aer isotype switching.

CD39+/CD73+ surface expression was prominent on MZB cells, with less

presence on FO and NF-B cells.

Discussion: Our intervention-triggered antigens exposed tumors, initi-

ating germinal centers and promoting anti-tumoral immune structures

in spleen and tumor tissues. MZ-B cells may have strong immunosup-

pressive potential, shown by increased CD39/CD73 expression in spleen,

lymph nodes, and tumors. Reduced CD39+/CD73+ expression on FO-B

cells in tumor-related tissues, compared to increased expression on MZ-B

cells, highlights distinct roles in tumor progression. IgG1, IgG2, and IgG3

concentrations rising later in the experiment suggests follicular B cells

rene antibodies; elevated IgM levels might result from augmented mar-

ginal zone B cells.

Conclusion: Investigating diverse B cell populations in HNSCC mice and

human patients, despite incomplete understanding of tertiary lymphoid

structures (TLS) implications, promises progress. Unraveling intricate

interactions between B cell subsets and tumor microenvironment oers

innovative ways to enhance HNSCC treatment and prognosis.

Disclosure Statement: e authors declare no conict of interest.

Health Economy/Public Health

663

Financial Distress in German Cancer Patients. Results from

a Quantitative Survey

Sophie Pauge1; Andrea Züger2; Viktoria Mathies3; Katja Mehlis2;

Bastian Surmann1; Thomas Ernst3; Wolfgang Greiner1; Natalja Menold4;

Eva Winkler2; Luise Richter4

1Bielefeld University, Department for Health Economics and Health Care

Management, Bielefeld, Deutschland

2National Center for Tumor Diseases (NCT) Heidelberg, Department of Medical

Oncology, Heidelberg, Deutschland

3Jena University Hospital, Department of Internal Medicine II, Hematology and

Medical Oncology, Jena, Deutschland

4Dresden University of Technology, Institute of Sociology, Dresden, Deutschland

Background: Financial distress due to a cancer disease can impact quality

of life and distress [1]. Despite recognized counseling needs [2], system-

atically collected data on cancer patients’ nancial situation in Germany

remain limited [3]. To assess nancial distress in German cancer patients,

a quantitative survey was performed.

Methods: A paper-pencil survey including 266 cancer patients was

administered at two Comprehensive Cancer Centers. Demographic varia-

bles, disease characteristics, questions on the patients’ nancial situation,

and other patient-reported outcomes such as Depression and Anxiety

(PHQ-4) were included.

Result: On average, patients faced ~1.700€ in cancer-related expenses

over the past six months, including medical costs such as hospital stays

and medications, as well as non-medical expenses such as costs for house-

hold assistance and transportation. Furthermore, ~60% of patients expe-

rienced a signicant loss of income (p<.001), with the average monthly

net income changing from 2.000-2.499€ to 1.500€-1.999€. About 40 per-

cent of respondents reported moderate to severe nancial concerns, for

example regarding their own or their family’s nancial security. Financial

concerns also showed a signicant (p<0.001) association with Depression

(r=0.4) and Anxiety (r=0.4).

Discussion: Financial distress as a possible eect of cancer is a phenome-

non that even occurs in countries with universal healthcare coverage, such

as Germany. It is driven by emerging costs and loss of income due to diag-

nosis and treatment. In addition the link between nancial concerns and

Depression and Anxiety underscores the need for patient support.

Conclusion: Identifying patients at high risk of nancial distress is crucial

for providing personalized and coordinated interventions that can miti-

gate the impact of cancer-related nancial challenges.

Literature:

1 Mehlis, K. et al., BMC Cancer, 2020.

2 Surmann, B. et al., ZEFQ, 2021.

3 Lueckmann, SL et al., Onkologe, 2021.

Disclosure Statement: e authors declare no conict of interest.

Hematooncology including Bone marrow

transplantation, Lymphoma, Plasmocytoma

378

Comprehensive analysis of treatment related morbidity and

progression-free survival in the GHSG phase III HD21 trial

Justin Ferdinandus1,2; Alden Moccia3,4; Richard Greil5,6;

Gundolf Schneider1,2; Valdete Schaub7; Andreas Hüttmann8; Felix Keil6,9;

Judith Dierlamm10; Mathias Hänel11; Urban Novak4,12; Julia Meissner13;

Andreas Zimmermann14; Stephan Mathas15; Andreas Viardot16;

Bernd Hertenstein17; Sonja Martin18; Stefanie Kreissl1,2; Michael Fuchs1,2;

Andreas Rosenwald2,19; Wolfram Klapper2,20; Hans-Theodor Eich2,21;

Christian Baues2,22; Michael Hallek1; Markus Dietlein2,23; Carsten Kobe2,23;

Volker Diehl1,2; Peter Borchmann1,2

1Klinik I für Innere Medizin und CIO Aachen Bonn Köln Düsseldorf, Uniklinik

Köln, Köln, Deutschland

2Deutsche Hodgkin Studiengruppe (GHSG), Köln, Deutschland

3Oncology Institute of Southern Switzerland, Bellinzona, Schweiz

4Swiss Group for Clinical Cancer Research, Bern, Schweiz

5Illrd Medical Department, Paracelsus Medical University, Salzburg, Österreich

6Arbeitsgemeinschaft medikamentöser Tumortherapie (AGMT), Salzburg,

Österreich

7Innere Medizin II, Universitätsklinikum Tübingen, Tübingen, Deutschland

8Klinik für Hämatologie und Stammzell transplantation, Universitätsklinikum

Essen, Essen, Deutschland

93. Medizinische Abteilung, Hanusch Krankenhaus, Wien, Deutschland

10II. Medizinischen Klinik und Poliklinik, Universitätsklinikum Hamburg-

Eppendorf, Hamburg, Deutschland

11Klinik für Innere Medizin III, Klinikum Chemnitz, Chemnitz, Deutschland

12Medizinische Onkologie, Universitätsspital Bern, Bern, Schweiz

13Medizinische Klinik und Poliklinik V, Universitätsklinikum Heidelberg,

Heidelberg, Deutschland

14Medizinische Klinik Und Poliklinik III, Klinikum Der Universität München, LMU

München, München, Deutschland

15Klinik für Hämatologie und Onkologie, Charité Berlin, Berlin, Deutschland

16Klinik für Innere Medizin III, Universitätsklinikum, Ulm, Ulm, Deutschland

17Medizinische Klinik I, Klinikum Bremen-Mitte, Bremen, Deutschland

18Hämatologie, Onkologie und Palliativmedizin, Robert-Bosch-Krankenhaus,

Stuttgart, Deutschland

19Pathologisches Institut, Uniklinikum Würzburg, Würzburg, Deutschland

20Institut für Pathologie Sektion Hämatopathologie, Universitätsklinikum

Schleswig-Holstein, Kiel, Deutschland

21Klinik für Strahlentherapie – Radioonkologie, Universitätsklinikum Münster,

Münster, Deutschland

22Radioonkologie und Strahlentherapie Ruhr-Universität Bochum, Bochum,

Deutschland

23Klinik für Nuklearmedizin, Uniklinik Köln, Köln, Deutschland

Background: e GHSG-HD21 trial for newly diagnosed adult patients

(pts) with advanced-stage classical Hodgkin lymphoma (AS-cHL) com-

pares BrECADD to eBEACOPP. Prior analyses of co-primary endpoints

demonstrated a signicant and relevant reduction in treatment-related

morbidity (TRMB) and non-inferiority of PFS. We report the rst com-

prehensive analysis of the combined primary endpoint of HD21.

Methods: is international open-label phase III trial included adult

pts aged ≤ 60 yrs with AS-cHL. Pts were randomized in a 1:1 ratio to

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts14

PET2-guided 4-6 cycles of either eBEACOPP or BrECADD. PFS was

determined at interim analysis at 36 month FU. PET2 and PFS events were

assessed by blinded panel review. e trial was registered at clinicaltrials.

gov (NCT02661503) and conducted according to ICH-GCP guidelines.

Result: We enrolled 1,500 pts from 9 countries and 233 trial sites between

July 2016 and August 2020. Actual median FU for this analysis was 40

months. e relative risk for a TRMB event was 0.72 (CI95 0.65-0.79) in

favor of BrECADD observed in all subgroups. Fewer dose reductions were

needed with BrECADD than with eBEACOPP. 59% of pts had a PET2-

negative remission (CMR) and were treated with a total of 4 cycles in each

group. At end of chemotherapy, 80% and 82% were in CMR. 3y PFS was

94.9% for BrECADD (CI95 93.5% - 96.7%), and 92.3% for eBEACOPP

(CI95 90.3% - 94.3%; HR 0.63 [CI95 0.42-0.94]). HRs favored BrECADD

consistently across all relevant subgroups. 3y PFS rates for BrECADD

versus eBEACOPP were 97.1% (CI95 95.5% - 98.7%) versus 93.6% (CI95

91.3% - 95.9%) for PET2-negative pts and 93.5% (CI95 90.6% - 96.5%)

versus 90.6% (CI95 87.1% - 94.1%) for PET2-positive pts, respectively.

Discussion: With the novel BrECADD regimen, we observed the highest

3y PFS rates reported to date in a randomized clinical trial in AS-cHL. Our

analyses suggest the unexpectedly high ecacy of the new BrECADD regi-

men to be direct consequence of its improved tolerability and deliverability.

Conclusion: Individualized treatment with 4-6 cycles of BrECADD is a

new standard of care for AS-cHL.

Disclosure Statement: e authors declare the following: Speaker fees received

Roche and Takeda Oncology.

Imaging

754

Impact of FAPI/dual tracer PET/CT imaging on management

and target volume denition of esophageal cancer

Simone Wegen1; Karina Claus1; Philipp Linde1; Johannes Rosenbrock1;

Thomas Zander2,3; Armin Tuchscherer2,3; Wolfgang Schröder4;

Hans Schlößer4,5; Marie-Lisa Eich6; Thomas Fischer7; Klaus Schomäcker7;

Alexander Drzezga7,8; Carsten Kobe7; Katrin Sabine Roth7;

Jasmin Weindler7

1Department of Radiation Oncology, Cyberknife and Radiotherapy, Faculty of

Medicine and University Hospital Cologne, Cologne, Deutschland

2Department I of Internal Medicine, Faculty of Medicine and University Hospital,

University of Cologne, Cologne, Deutschland

3Center for Integrated Oncology, Faculty of Medicine and University Hospital,

University of Cologne, Cologne, Deutschland

4Department of General, Visceral, Cancer and Transplantation Surgery, Faculty

of Medicine with University Hospital Cologne, Cologne, Deutschland

5Center for Molecular Medicine Cologne, Faculty of Medicine and University

Hospital Cologne, Cologne, Deutschland

6Institute of Pathology, Faculty of Medicine and University Hospital Cologne,

Cologne, Deutschland

7Department of Nuclear Medicine, Faculty of Medicine and University Hospital

Cologne, University of Cologne, Cologne, Deutschland

8Institute of Neuroscience and Medicine, Molecular Organization of the Brain,

Forschungszentrum Jülich, INM-2, Cologne, Deutschland

Background: Fibroblast activation protein (FAP) is expressed in the

tumor microenvironment (TME) of various cancers. We aim to describe

the impact of imaging with radiolabeled inhibitors of FAP (FAPI-46-PET/

CT) and uorodeoxy-D-glucose (FDG-PET/CT) on the management of

esophageal cancer (EC).

Methods:32 patients with EC received FDG and FAPI-46 PET/CT on

the same day (dual-tracer protocol, 71%) or on two separate days (29%).

We compared functional tumor volumes (FTV) in ml and dened gross

tumor volumes (GTV) and cN/cM- tumor stages based on both imag-

ing modalities. Any management changes were categorized as “minor”

(adaption/enlargement of radiation (RT) eld) or “major” (change of

treatment). Immunohistochemistry (IHC) staining for FAP was done in

all patients with available tissue.

Results: Primary tumor was detected in all FAPI-46 scans and in 30/32

(93%) of FDG scans. Most FTVs were larger on both dual-tracer PET/

CT (p=0.027) and FAPI-46 PET/CT (p=0.028) compared to FDG PET/CT

alone. 12/32 patients (38%) were upstaged in nodal status aer both FDG

and FAPI-46 PET scan. Here, 10/12 lesions were concordant between both

modalities. ree lymph nodes were visible in FAPI-46/dual-tracer only,

leading to increased RT elds (“minor change”) in 7/32 patients (21%)

and changing treatment regimen (“major change”) in 3/32 patients (9%).

PET scans revealed distant metastasis in 2/32 (6%) patients in the PET

with FAPI-46. GTVs were signicantly larger in FAPI-46/dual-tracer

scans than in FDG PET/CT (mean 99.0ml, SD 98.3 vs. mean 80.3ml, SD

84.4, respectively (p<0.001)). All tissues analysed (43%) showed FAP-

positivity (7%-45% of cells, IHC scoring (H-score) mean 36.3 (SD 24.6)).

Discussion: We report rst data on the use of PET with FAPI-46 prior to

RT indicating relevant impact on management of EC, likely driven by high

FAP expression in the TME. Still, false-positive FAPI-46 PET/CT ndings

should be considered.

Conclusion:PET/CT with FAPI-46 is an attractive staging tool for EC and

leads to changes in treatment. e impact on clinical outcome should be

evaluated prospectively.

Disclosure Statement: e authors declare no conict of interest.

Novel Therapeutics: Targeted Therapies,

Immunotherapies, Cellular Therapies

Drug sensitivity proling of 3D tumor tissue cultures in the

pediatric precision oncology program INFORM

Heike Peterziel1; Sonja Herter1; Xenia Gerlo 1; Luisa Becker2;

Robert J Autry2; Tim Holland-Letz3; Annette Kopp-Schneider3;

Olaf Witt1; Ina Oehme1

1DKFZ / KiTZ / NCT, CCU Pediatric Oncology, Heidelberg, Deutschland

2DKFZ / KiTZ / NCT, Division of Pediatric Neurooncology, Heidelberg,

Deutschland

3DKFZ, Division of Biostatistics, Heidelberg, Deutschland

Background: e international precision oncology program INFORM

enrolls relapsed pediatric cancer patients for comprehensive molecular

analysis. We recently implemented functional ex vivo drug sensitivity pro-

ling (DSP) in this international multicenter precision oncology program

(1). Here, we will provide an update on the progress on predictivity of the

pipeline.

Methods: We received 350 viable tumor samples from 35 pediatric oncol-

ogy centers in seven countries. DSP was conducted on multicellular fresh

tumor tissue spheroid cultures in 384-well plates and metabolic viability

read-out; hits were reported to the respective tumor board within three

weeks.

Result: In 204 cases (58%), sucient viable tissue was received and passed

internal quality controls. e DSP results matched the identied molecular

targets, including ALK, MET, and TP53 status. Unexpected drug vulner-

abilities were identied in 80% of cases lacking actionable clinically rele-

vant molecular events, demonstrating the added value of DSP. To visualize

the data and to identify outlier responses, we developed an interactive and

comprehensive Shiny/R application (COBRA). To rank patient-individual

drug sensitivities within the cohort, we applied the Jenks natural breaks

classication, a clustering method designed to minimize dierences

within a class and maximize dierences between classes. Striking parallels

between clinical courses and the DSP results were observed in selected

patients, pointing toward potential predictivity of DSP.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 15

Discussion: e next steps include the systematic validation of the plat-

form with clinical outcome data and the development of prospective clin-

ical trials.

Conclusion: Overall, DSP provides added value to molecular data and is

feasible in international multicenter precision oncology programs, such as

INFORM, in clinical real-time.

Indication of source:

(1) Peterziel H et al. Drug sensitivity proling of 3D tumor tissue cultures in the

pediatric precision oncology program INFORM. NPJ Precis Oncol. 2022 Dec

27;6(1):94.

Disclosure Statement: e authors declare the following: O.W. participated in

the advisory boards of Novartis, BMS and Janssen and received research grants

from BVD, Day One erapeutics. e remaining authors declare no competing

interests.

184

Mimetics of Tumor Suppressor Proteins as Novel Drug

Candidates for Personalized Cancer Therapy

Edgar Dahl1,2; Sophia Villwock1,2; Peter Habenberger3; Axel Choidas3;

Danny Jonigk1,2; Michael Rose1,2; Bert Klebl3

1Institute of Pathology, Medical Faculty, RWTH Aachen University, Aachen,

Deutschland

2Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO

ABCD), Aachen, Deutschland

3Lead Discovery Center GmbH (LDC), Dortmund, Deutschland

Background: A novel therapeutic strategy is proposed to target hard-

to-treat (HTT) cancers by exploiting phenotypic mimicry of proteins

encoded by tumor suppressor genes (TSGs), particularly class 2 TSGs (or

C2TSGs) silenced by DNA promoter methylation. In contrast to exist-

ing targeted therapies that rely on drugs targeting driver alterations, this

approach focuses on mimicking the lost tumor suppressor function by

small molecule compounds.

Methods: e proposed approach involves identication of C2TSG

candidates, biological validation of their signicance, and subsequent

high-throughput screening (HTS) for mimetic drug candidates. Our pilot

study focused on dening mimetics for the tumor suppressor protein

SFRP1, a well-known inhibitor of the WNT pathway. Breast cancer cell

lines transfected with the SFRP1 gene or a control vector were used for the

phenotypic assay, and the CellTiter-Glo® Luminescent Cell Viability Assay

was used to determine tumor cell proliferation.

Results: In an HTS of 189,250 compounds, 430 potential SFRP1 mimetic

hits were identied. Secondary assays, including analysis of Wnt pathway

reporter genes, narrowed the hits to 59 compounds. Most candidates cor-

rectly modulate expression of known SFRP1 targets in our system (i.e.

PCDH10 and COL12A1) reecting correct simulation of SFRP1 function

by the candidate mimetic drugs. Several lead mimetics (e.g. LDC066)

downregulate the phosphorylated LRP6 receptor and cyclin D1, key ele-

ments of the Wnt signalling pathway. Lead mimetic compounds are cur-

rently being tested in dierent mouse models.

Discussion: e shi toward personalized targeted therapies has trans-

formed cancer treatment by focusing on actionable genetic alterations.

However, many challenges remain, particularly in cancers such as pan-

creatic and liver cancers. is innovative strategy of tumor suppressor

protein mimetics may represent a promising approach for the treatment

of HTT cancers.

Conclusion: We present a new therapeutic platform for personalized can-

cer medicine based on specic tumor suppressor protein mimetics.

Disclosure Statement: e authors declare the following: Gesellschaer der

Qithera.

514

Scaling access to Precision Oncology in Germany – The AIO

German Transsectoral Exchange Platform (TEAM-D;

AIO-TF-0323)

Sebastian Lange1; Alexander Desuki2; Annalen Bleckmann3,4;

Sonja Loges5; Anke Reinacher-Schick6; C. Benedikt Westphalen7;

Ina Pretzell8

1II. Medizinische Klinik und Poliklinik am Klinikum rechts der Isar, Technische

Universität München, München, Deutschland

2Universitäres Centrum für Tumorerkrankungen (UCT) Mainz,

Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz,

Deutschland

3Westdeutsches Tumorzentrum, Universitätsklinikum Münster, Münster,

Deutschland

4Medizinische Klinik A, Universitätsklinikum Münster, Münster, Deutschland

5Abteilung für Personalisierte Onkologie, Universitätsmedizin Mannheim,

Medizinische Fakultät Mannheim, Universität Heidelberg, Heidelberg,

Deutschland

6Klinik für Hämatologie, Onkologie mit Palliativmedizin, St. Josef-Hospital,

Klinikum der Ruhr Universität, Bochum, Deutschland

7Medizinische Klinik und Poliklinik III und CCC München, Klinikum der

Universität München, LMU München, München, Deutschland

8Westdeutsches Tumorzentrum, Universitätsklinikum Essen, Essen, Deutschland

Background: e impact of precision oncology has increased over the past

decade. However, extensive molecular proling has unveiled numerous

genomic alterations with therapeutic impact but without approved treat-

ments. is has prompted the establishment of multidisciplinary molec-

ular tumor boards (MTBs) to interpret these alterations. In Germany,

several initiatives aim to integrate precision oncology into routine patient

care. However, exchange on daily practice in precision oncology across

dierent healthcare sectors needs strengthening. e positive Bavarian

cross-site MTB experiences within the Bavarian Cancer Research Center

resulted in the concept of a national, transsectoral, low-threshold peer

exchange platform.

Methods: e virtual Transsectoral German Peer Exchange Platform

(TEAM-D) is an AIO project (Arbeitsgemeinscha Internistische

Onkologie; #AIO-TF-0323) and oers multidisciplinary exchange on

complex clinical questions in German MTBs. e platform was promoted

through various professional channels, including the AIO network, and

presented to DNPM (German Network for personalized medicine) and

BNHO (Professional Association of German Practicing Physicians for

Hematology and Oncology) members. Focusing on specic genomic

alterations in 90-minute sessions, TEAM-D aims to gather, assess, and

publish discussions, recommendations, and case reports, thereby contrib-

uting to evidence generation and harmonizing precision oncology.

Result: Results of the discussions and polls from the rst four meetings

addressing (i) PIK3CA, (ii) AKT/ mTOR/ PTEN, (iii) BRCA, and (iv)

non-BRCA HRD (held July - December 2023), will be presented at the

meeting.

Discussion: e rst case discussions received ample interest with >40

participants from >20 university and community hospitals and pro-

vided important insights into the practice of German precision oncology

programs.

Conclusion: TEAM-D oers a transsectoral peer exchange platform for

recurring questions in German MTBs.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts16

800

Improved Tumor Cell Killing by Combining iiT8 Eector Cells

and Bispecifc EGFRxNKp30 Engagers

Hannes Forkel1; Maren Depke1; Sascha Troschke-Meurer2; Ammelie Svea

Boje3; Katja Klausz3; Lukas Pekar4; Stefan Zielonka4; Christian Andreas

Schmidt1; Matthias Peipp3; Piotr Grabarczyk1

1Universitätsmedizin Greifswald, Comprehensive cancer center MV, Greifswald,

Deutschland

2Universitätsmedizin Greifswald, Department of pediatric hematology and

oncology, Greifswald, Deutschland

3Universitätsklinikum Schleswig-Holstein, Department of Medicine II, Division

of Antibody-Based Immunotherapy, Kiel, Deutschland

4Protein Engineering and Antibody Technologies Merck Healthcare KGaA,

Darmstadt, Deutschland

Background: Loss of BCL11B in human CD8+ T cells leads to the forma-

tion of highly cytotoxic induced innate CD8+ T (iiT8). e development

of bispecic T cell engagers opened the door to an improved engagement

of eector cells like the iiT8 cells to the target tumor cells.

Methods: Human peripheral blood alpha-beta CD8+ T cells were isolated

from buy coats of healthy donors using magnetic separation and knock-

out of BCL11B was induced using the CRISPR/Cas9 system. Eector

cell-mediated killing using NKp30xEGFR engagers against A549 lung

carcinoma spheroids or LAN-1 neuroblastoma spheroids was measured.

Result: Combination of iiT8 cells with EGFRxNKp30 bispecic engager

led to higher lysis of A549 or LAN-1 target cells compared to negative

control antibody or Cetuximab. Presence or absence of a functional

non-mutated Fc-domain of the engager did not inuence cytotoxic activ-

ity, likely due to low FcgRIIIa expression levels on iiT8 cells.

Discussion: e iiT8 cells are characterized by high spontaneous cyto-

toxicity mediated by the NKp30 B7H6 axis, but show reduced anti-tumor

activity if stress ligands are missing on the target cells. Addition of the

bispecic EGFRxNKp30 engager utilized the high surface expression of

NKp30 on the iiT8 cells and enabled cytotoxic activity against tumor cells

expressing low amounts of stress ligand B7H6 but are positive for EGFR.

Conclusion: Combinatory application of iiT8 cells and bispecic engag-

ers represents a promising tool for a variety of anti-cancer therapies by

adding adaptable specicity via bispecic engager to highly cytotoxic iiT8

eectorcells.

Disclosure Statement: e authors declare the following: S.Z and L.P. are

employees of Merck Healthcare KGaA Darmstadt.

Onkologische Pege

151

Standardized nursing consultation for patients with breast

and ovarian cancer under treatment with oral tumor therapy

in gynecological oncology: Evaluation of an interprofessional

webinar within the prospective CAMPA initiative

Franziska Henze1; Lisa Hirschberg1; Sophie Winkler1; Valeria Milani2;

Timo Schinköthe3,4; Renate Haidinger5; Kerstin Paradies6; Sven Mahner1;

Fabian Trillsch1; Nadia Harbeck1; Rachel Würstlein1

1Breast Center, Dept of Gynecology and Obstetrics and CCC Munich, LMU

University Hospital, LMU Munich, München, Deutschland

2Facharztzentrum Fürstenfeldbruck, Fürstenfeldbruck, Deutschland

3CANKADO GmbH, Ottobrunn, Deutschland

4Research Center Smart Digital Health, University of the Bundeswehr Munich,

München, Deutschland

5Brustkrebs Deutschland e.V., Hohenbrunn, Deutschland

6Konferenz Onkologischer Kranken- und Kinderkrankenpege (KOK) in der

Deutschen Krebsgesellschaft e.V., Hamburg, Deutschland

Background: e increase of oral tumor therapy (OTT) presents new

challenges for patient care. Within CAMPA (Care improvement for met-

astatic breast and ovarian cancer patients treated with PARP-inhibitors),

a complementary nursing consultation for patients treated with PARP-

inhibitors is evaluated and information material as well as training for

nurses are implemented.

Methods: Since 02/22, quality of life (QoL), adherence, and adverse

events (AEs) have been evaluated in the oral gynecooncological setting

including standardized nursing support and using questionnaires and

CANKADO-ePRO. Satisfaction with care has been recorded since 03/23.

A specic webinar was developed in the setting of nursing consultation.

Questionnaires are used to track gain of knowledge through nursing

trainings (07-09/23). A total of 1300 participants have been invited for

evaluation of the webinar.

Result: e patient population (n=50) includes 45 patients with ovarian and

5 with breast cancer, receiving special nursing support. At the beginning of

the OTT, patients rate their QoL with approximately 4.2 out of 7 points. In

the further course, QoL increases to 5.8 points. With an average of 4.95 out

of 5 points, satisfaction with CAMPA care is very high. In the webinar, these

results, information material and content on how to conduct and optimize

nursing consultation are explained. Evaluation data will be presented.

Discussion: e large decline in AEs by 66% aer the rst three months

of therapy is highly relevant for the improvement of QoL by 40% in oral

gyneco-oncological treatment. ere is great potential in complementary

nursing support through adequate management of these AEs and adher-

ence to adjuvant, metastatic and/or maintenance therapy.

Conclusion: Especially in the rst months of OTT, intensied care is

essential for QoL, adherence and management of AEs. Standardized nurs-

ing training and consultation is an important contribution to the increas-

ing number of oncological patients under oral therapy and for this aim an

interprofessional webinar represents a highly appreciated tool.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

Psychooncology

168

Beating Cancer-Related Fatigue with the Untire App:

ARandomized Controlled Trial Assessing Ecacy and

Safety among German Patients with Moderate-to-Severe

Cancer-Related Fatigue

Simon Spahrkäs1; Katharina Abraham2; Fatemeh Akbari1; Hp Zenner3;

Bram Kuiper1; Hans Reitsma2; Ewoud Schuit2

1Tired of Cancer, Utrecht, Niederlande

2THINC. The Healthcare Innovation Center, Utrecht, Niederlande

3HNO-Privatpraxis Tübingen | Prof. Dr. H. P. Zenner, Tübingen, Deutschland

Background: is RCT examined the clinical ecacy and safety of the

German language version of the Untire app digital health application (i.e.,

DiGA) in reducing fatigue and enhancing quality of life among cancer

patients. e hypothesis was that supplementing care-as-usual with the

app access would yield superior outcomes for patients suering from

moderate to severe fatigue over 12 weeks.

Methods: Patients with moderate to severe cancer-related fatigue (CRF)

were recruited via newspaper and social media advertisements through-

out Germany and randomized (1:1) to care-as-usual (n=111) or care-

as-usual plus Untire app (n=104). Baseline, 4, 8, and 12-week assessments

included fatigue, quality of life, stress, depression, and anxiety. Linear

mixed models ANCOVAs examined 12-week treatment eects, adjusting

for baseline values within intention-to-treat.

Results: By week 12, the intervention group showed signicantly reduced

fatigue (p=0.0016, d = 0.47), exceeding the clinically relevant minimal

clinically important dierence (MCID: -0.57). Disease-related quality of

life also signicantly improved (p=0.0178, d = 0.35). Subgroup and sensi-

tivity analyses supported consistent treatment eects and robustness.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 17

Discussion: is study conrms the German Untire app’s ecacy and

safety in reducing fatigue and improving quality of life among cancer

patients and survivors with moderate to severe fatigue. Subgroup analy-

ses indicate consistent treatment eects regardless of app engagement or

demographic characteristics.

Conclusion: e German Untire app proves eective and safe for moder-

ate to severe cancer-related fatigue.

Disclosure Statement: e authors declare the following: Spahrkäs, Akbarim and

Kuiper are employed by Tired of Cancer.

Sarcoma

825

Are treatment delays associated with a worse outcome in

patient with high-grade osteosarcoma? A retrospective

analysis of data from the EURAMOS-1 trial

Dimosthenis Andreou1; Stefanie Hecker-Nolting2; Daniel Baumhoer3;

Leo Kager4; Matthias Kevric2; Thomas Kühne5; Andreas Leithner1;

Benjamin Sorg2; Per-Ulf Tunn6; Reinhard Windhager7; Stefan Bielack2

1Medizinische Universität Graz, Graz, Österreich

2Klinikum Stuttgart - Olgahospital, Stuttgart, Deutschland

3Universitätsspital Basel, Basel, Schweiz

4St. Anna Kinderspital, Wien, Österreich

5UKBB - Universitäts-Kinderspital beider Basel, Basel, Schweiz

6Helios Klinikum Berlin-Buch, Berlin, Deutschland

7Medizinische Universität Wien, Wien, Österreich

Background: e logistics of multidisciplinary treatment of high-grade

osteosarcoma may sometimes lead to treatment delays. e aim of this

study was to evaluate the impact of such delays on patient prognosis.

Methods: Data from 1671 patients with localized, high-grade osteosarcoma

recruited in the EURAMOS-1 trial (NCT00134030) and undergoing sur-

gical treatment aer induction chemotherapy were analyzed. e optimal

cut-o values for survival analyses were calculated with receiver operating

characteristics curves. Hazard ratios (HR) were estimated with their respec-

tive 95% condence intervals (CI) in multivariate Cox regression models.

Result: e median duration of symptoms amounted to 8 (interquartile

range (IQR), 4-13) weeks, while the median interval between the begin-

ning of induction chemotherapy and surgery was 82 (IQR, 76-90) days.

e median time between surgery and the beginning of consolidation

chemotherapy was 19 (IQR, 14-24) days. A longer duration of symptoms

was associated with a higher tumor volume at diagnosis (234ml vs. 134ml,

p=0.003), but not with a higher risk for death (HR 1.43, 95%CI 0.82-2.49;

p=0.212). On the other hand, both delays between the beginning of induc-

tion chemotherapy and surgery (HR 1.87, 95%CI 1.10-3.21; p=0.022)

and delays between surgery and consolidation chemotherapy (HR 1.46,

95%CI 1.02-2.08; p=0.037) were associated with a higher risk for death.

Discussion: Delays during induction chemotherapy and a delayed start

of consolidation chemotherapy aer surgery are independently associated

with a poorer survival in patients with localized osteosarcoma.

Conclusion: Our results underscore the need to optimize referral path-

ways between dierent departments and hospitals in order to avoid

unnecessary treatment delays.

Disclosure Statement: e authors declare no conict of interest.

Supportive Care

240

Results of the module physical activity in the CARE for CAYA

program - a need-based multimodal lifestyle survivorship

program focusing on physical activity, nutritional behavior

and psychological processes in survivors of cancer in

childhood, adolescence and young adulthood

Simon Elmers1; Julia von Grundherr1; Gabriele Calaminus2; Sonja

Schuster3; Annette Sander4; Alexander Puzik5; Inken Hilgendorf6; Judith

Gebauer7; Michael Köhler8; Jörg Faber9; Nicole Salzmann10; Magdalena

Sokalska-Duhme11; Ronja Beller12; Anne Kollikowski13; Luzia Valentini14;

Freerk T. Baumann15; Eik Vettorazzi1; Wiebke Jensen1; Jannike Salchow1;

Sarah Dwinger1; Alexander Stein1; Carsten Bokemeyer1; Marianne Sinn1

1Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland

2UKB Universitätsklinikum Bonn, Bonn, Deutschland

3Kinder- und Jugendklinik, Erlangen, Deutschland

4Medizinische Hochschule Hannover Klinik für Pädiatrische Kardiologie und

Intensivmedizin, Hannover, Deutschland

5Medizinische Fakultät der Albert-Ludwigs-Universität Freiburg, Freiburg im

Breisgau, Deutschland

6Universitätsklinikum Jena, Jena, Deutschland

7Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Deutschland

8Universitätsklinikum Magdeburg, Magdeburg, Deutschland

9Universitätsmedizin Mainz, Mainz, Deutschland

10Klinik für Kinder- und Jugendmedizin - Pädiatrische Hämatologie und

Onkologie, Münster, Deutschland

11Olgahospital und Frauenklinik | Klinikum Stuttgart, Stuttgart, Deutschland

12Universitätsklinikum Essen, Essen, Deutschland

13CCC Comprehensive Cancer Center Mainfranken, Würzburg, Deutschland

14Hochschule Neubrandenburg, Neubrandenburg, Deutschland

15Uniklinik Köln, Köln, Deutschland

Background: Late and long-term eects oen occur aer a cancer diag-

nosis in childhood, adolescence or young adulthood (CAYA). A healthy

lifestyle and regular physical activity (PA) can reduce the risk of these

sequelae. To improve the PA behavior of CAYAs, a PA-associated module

was developed within the multicenter CARE for CAYA program (CFC-P).

Methods: e CFC-P included comprehensive assessment to determine

initial ‘high need’ (T1). CAYAs could participate in up to three modules

(Psycho-oncology, Nutrition, PA) over 52 weeks (T3). In module PA,

the intervention group (IG) received up to ve counselling sessions as

well as nine newsletters while the control group (CG) received only one

counselling session. All participants received guideline-based motivation

via counselling to adopt a more active lifestyle and body measurements.

Primary endpoint was dened as an increase in PA (BSA-questionnaire

and accelerometry via ActiGraph wGT3X-BT). Secondary endpoints were

self-reported PA, reduction in exercise-related barriers, improvement in

quality of life (QoL) and fatigue.

Result: A total of 357 CAYAs participated at 14 survivorship clinics in

Germany as part of the RCT, of whom 63.0% (n=226) were female. Median

age was 25.0 years and median time since diagnosis was 60 months. e

‘high need’ in PA was 53.3% (IG = 97, CG = 89) at T1 and 45.7% (IG =

67, CG = 56) at T3. Modular endpoints were assessed on an exploratory

basis. Both groups improved their weekly mean leisure-time activities in

minutes (IG: T1 = 250, T3 = 320; CG: T1 = 250, T3 = 270), but neither PA

for sports purposes nor total activity or number of steps improved. QoL

and fatigue improved in both groups with no dierences between groups.

Conclusion: e CFC-P has shown a high demand in multimodal sup-

port among CAYAs, also in the area of PA. One-o professional counsel-

ling on PA as part of regular support for CAYAs seems reasonable. e

additional counseling should be combined with guided, practical exercise

sessions and measurements over a dened period of time in order to be

able to achieve further positive eects.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts18

Disclosure Statement: e authors declare the following: AOK Germany, Astra

Zeneca, Bayer Healthcare, BioNTech, Bristol Myers Squipp, Jansen Cilag, med update,

Merck Serono, On-cology Drug Consult CRO, Roche Pharma, Sano Aventis,

Hamburg Cancer Society, National Network of German Cancer Cen-ters, Northern

German Society of Internal Medicine, DGHO, BeiGene, Janssen-Ciliag, medac,

Celgene, JazzPharmazeuticals, Fondazione Internationale Menarini, BMS, MSD,

Incyte, Pzer, Servier, Amgen, Incyte, Pierre Fabre, Biegene, AbbVie, Novartis.

429

The metabolite prole of extracellular vesicles reects the

nutritional status of lung cancer patients

Said Naser; Matthias Schulz; Judith Büntzel

Klinik für Hämatologie und Medizinische Onkologie, Universitätsmedizin

Göttingen, Göttingen, Deutschland

Introduction: Extracellular vesicles (EVs) are small, membrane-bound

structures released by cells into the extracellular space, oering valuable

insights into the metabolite prole of their parent cells. Secreted into the

blood, they are also available for diagnostics. Cachexia, a frequent occur-

rence among cancer patients (CP), signicantly aects both treatment-

related toxicity and overall survival. Despite this, an eective blood marker

for identifying cachexia has not been identied yet. is study investigates

dierences in the metabolite prole of patients with stable weight (SW)

and with weight loss (WL).

Methods: EVs were isolated by dierential centrifugation from the

peripheral blood of SW and WL patients. Targeted mass spectrometry

was performed using the MxP Quant 500 Kit on an LC-QTRAP 5500

mass spectrometer. Patient records provided data on weight development

(time of sample collection and six months later). Weight loss exceeding

5% within six months was deemed clinically relevant. e open soware

MetaboAnalyst was used for data analysis. Signicant metabolite alter-

ations were identied using volcano plot analysis. Primary component

analysis and heat-map were used for comparisons.

Results: A dataset of 45 CP was analysed. Volcano plot analysis yielded

ve signicant (p < 0.05) metabolites. Amongst those were three metabo-

lites upregulated in WL - triacylglycerols (TG (20:0_34:1) and diacylglyc-

erols (DG (18:0_20:0), DG (18:1_22:6)). Additionally, two downregulated

phosphatidylcholines were found (PC ae C34:2, PC ae C36:3). However,

primary component analysis was unable to distinguish between the two

groups.

Discussion: Metabolic changes manifest at the time of blood collection,

predating the onset of weight loss. is underscores the existence of a

“cancer cachexia metabolome”. To solidify lipids as biomarkers for cancer

cachexia, extensive cohorts are needed for validation.

Conclusion: Metabolic proling might be a good biomarker to anticipate

weight loss in CP.

Disclosure Statement: e authors declare no conict of interest.

813

Enhancing Patient Activation: Eects of an interprofessional

counseling program on complementary and integrative

health care (CIH) at Comprehensive Cancer Centers

(CCC-Integrativ study)

Jan Valentini1; Daniela Fröhlich1; Inka Rösel1,2; Regina Stolz1; Cornelia

Mahler3; Peter Martus2; Nadja Klafke4; Markus Horneber5; Claudia Witte6;

Klaus Kramer7; Christine Greil8; Barbara Grün9; Katrin Tomaschko10;

Stefanie Joos1

1Institute for General Practice and Interprofessional Care, University Hospital

and Faculty of Medicine Tuebingen, Tübingen, Deutschland

2Institute for Clinical Epidemiology and Applied Biostatistics, University Hospital

and Faculty of Medicine Tuebingen, Tübingen, Deutschland

3Department of Nursing Science, Institute for Health Sciences, University

Hospital and Faculty of Medicine Tuebingen, Tuebingen, Tübingen, Deutschland

4Department of General Practice and Health Services Research, University

Hospital Heidelberg, Heidelberg, Deutschland

5Department of Internal Medicine, Division of Pneumology, Paracelsus Medical

University, Klinikum Nuernberg, Nürnberg, Deutschland

6aQua Institute for Applied Quality Improvement and Research in Health Care,

Goettingen, Göttingen, Deutschland

7Department of Integrative Medicine, University Hospital and Faculty of

Medicine Ulm, Ulm, Deutschland

8Department of Medicine I, Medical Centre University of Freiburg, Faculty of

Medicine, University of Freiburg, Freiburg, Deutschland

9Department of Medical Oncology, National Centre for Tumor Diseases,

Heidelberg, Deutschland

10AOK Baden-Württemberg Hauptverwaltung, Fachbereich Integriertes

Leistungsmanagement, Stuttgart, Stuttgart, Deutschland

Background: Complementary and integrative healthcare (CIH) oers the

chance to empower and activate cancer patients. Studies have shown that

higher patient activation is positively associated with improved quality

of life, better health outcomes and reduced healthcare costs. e CCC-

Integrativ study aimed to assess the implementation of an evidence-based

counseling program on CIH at four Comprehensive Cancer Centers

(CCC) in Baden-Wuerttemberg, Germany.

Methods: In this controlled implementation study, the patient-level

intervention included three CIH consultations within a 3-month period

delivered by specically trained, interprofessional teams of physicians and

nurses. Data collection took place at baseline (T1) and post- intervention

(T2). e primary endpoint was patient activation measured by PAM-13

at T2. Secondary endpoints included e.g. quality of life (EQ 5D) and self-

ecacy (SES6G), were compared between control (CO, receiving routine

care) and the intervention group (IG).

Result: A total of n=1,128 oncology patients (CO=443, IG=685) with

diverse tumor entities and cancer stages were included in the study.

e overall mean baseline PAM-13 score was 69.74 (SD=14.24) (n=959

(85.0%)). A statistically signicant between-group dierence in post-

intervention PAM-13 scores was observed (Fgroup(1, 1866.82)=8.634,

p=0.003), with an adjusted mean dierence of 2.22 PAM-points.

Analyses of secondary outcomes and health economic evaluations will

be reported.

Discussion: To the best of our knowledge, the CCC-Integrativ Study rep-

resents the largest cohort of cancer patients examined with PAM-13 in a

pre-post design to date. e new healthcare approach leads to a signi-

cantly higher level of patient activation compared to the CO.

Conclusion: Individually tailored counseling on CIH, oered by spe-

cically trained, interprofessional teams, signicantly improved patient

activation. e implementation of such a counseling program at cancer

centers may have benecial eects not only for patients but also for the

healthcare system.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 19

Thoracic Cancer

246

PD-L1 on large extracellular vesicles is a predictive biomarker

for therapy response in tissue PD-L1-low and -negative

patients with non-small cell lung cancer

Marcel Kemper1; Nadja Schöne1; Kerstin Menck1; Georg Evers1;

Carolin Krekeler1; Arik Bernard Schulze1; Georg Lenz1; Eva Wardelmann2;

Claudia Binder3; Annalen Bleckmann1

1Medizinische Klinik A, Universitätsklinikum Münster, Albert-Schweitzer-

Campus 1, Münster, Deutschland

2Universitätsklinikum Münster - Institut für Pathologie, Münster, Deutschland

3Klinik für Hämatologie und Medizinische Onkologie - Universitätsmedizin

Göttingen, Göttingen, Deutschland

Background: Tissue PD-L1 expression (tPD-L1) is currently the only

existing biomarker that positively correlates with the probability of

response to immune-checkpoint inhibitors (ICI) in patients with non-

small cell lung cancer (NSCLC). However, the predictive power of tPD-

L1 is limited, in particular in patients with low, or absent, tPD-L1. is

study tested whether extracellular vesicles (EVs) in plasma could be used

as novel predictive biomarkers in liquid biopsies for the response to ICI.

Methods: We isolated large EVs (lEVs) from NSCLC cell culture

supernatants as well as from peripheral blood of NSCLC patients

(n=108), non-cancer (n=23) and healthy (n=54) controls by dierential

ultracentrifugation. lEVs were characterized by electron microscopy,

nanoparticle tracking analysis, and immunoblot. Antigen expression on

patient-derived lEVs at baseline was measured by ow cytometry and

results were correlated with clinical data, including response to ICI-

containing therapy aer 3 and 6 months.

Result: We identied a panel of NSCLC-related antigens that were enriched

on lEVs from NSCLC cell lines. e levels of lEVs carrying these antigens

were elevated in plasma of NSCLC patients, discriminated them from controls

and had a prognostic value for patient survival. Among the antigens, PD-L1

showed the most striking increase and was mainly found on CD45–/CD62P−

lEVs. Patients with high levels of PD-L1+ lEVs showed a signicantly better

response to therapy, including ICI, and prolonged survival. is was particu-

larly true for the subgroup of patients with low or absent tPD-L1 expression.

Discussion: e predictive value of PD-L1+ lEVs at baseline outper-

formed tPD-L1. As cancer cells can export PD-L1 onto EVs, they might

better reect tumor heterogeneity and PD-L1 expression than the tPD-

L1 status. However, the origin of the PD-L1+ lEVs in plasma currently

remains elusive.

Conclusion: PD-L1+ lEVs are a novel predictive and prognostic bio-

marker for response to ICI in NSCLC that is superior to the standard-of-

care measurement of tPD-L1.

Disclosure Statement: e authors declare the following: is project was funded

by the Deutsche Forschungsgemeinscha (DFG, German Research Foundation -

project 424252458), the Else Kröner-Fresenius-Stiung (project 2019_A162), the

innovative medical research (IMF) of the Medical Faculty, University of Münster

(project ME 12 19 14), and Novartis (InCa Förderpre-is 2021).

Poster

Articial Intelligence in Cancer Care and

Diagnostics

Navigating Complexity in Radiation Therapy: Data Mining

and Large Language Models as Key Tools

Maximilian Grohmann; Cordula Petersen; Andrea Baehr

Universitätsklinikum Hamburg-Eppendorf, Klinik für Strahlentherapie und

Radioonkologie, Hamburg, Deutschland

Background: e ability to eciently analyze and structure this data

could lead to signicant improvements in radiation therapy planning and

personalization. However, analyzing and structuring radiation planning

data can be challenging due to its complexity and diversity.

Methods: We collected a year’s worth of radiation treatment data using a data

mining script through a Treatment Planning Soware application program-

ming interface. is data was subsequently analyzed and restructured using a

ne-tuned version of the Large Language Model (LLM) LLAMA2. e data-

set included a wide range of parameters, such as patient demographics, treat-

ment plan details, scheduled appointments, and medical history.

Results: We collected a year’s worth of radiation treatment data using a

custom-programmed data mining script to search through the database.

e LLAMA2 model identied patterns linking radiation doses or tech-

niques to patient reactions, assisting in treatment outcome predictions.

It also suggested renements to treatment plans drawn from similar

patient proles, enhancing planning eciency and quality. Additionally,

the model made predictions about specic side eects for patient subsets

using treatment protocols and histories.

Discussion: Utilizing AI models like LLMs in radiation data analysis

oers a transformative approach to enhance and personalize radiation

therapy planning. e LLAMA2 model’s capability to discern intricate

patterns showcases its utility in optimizing treatment strategies. While its

potential is evident, further research is paramount to validate its full eec-

tiveness and clinical relevance.

Conclusion: Our research highlights the profound impact of AI-driven

tools, specically the ne-tuned LLAMA2 model, on radiation treatment

data analysis. rough this approach, therapy planning becomes more tar-

geted and adaptable. Moreover, the methodologies and insights obtained

can be extended to other medical disciplines.

Disclosure Statement: e authors declare no conict of interest.

452

ChatGPT’s Performance in German OB/GYN Exams – Paving

the Way for AI-Enhanced Clinical Care

Maximilian Riedel1, Katharina Känger1, Antonia Stuehrenberg1,

Viktoria Ritter1, Niklas Amann2, Anna Graf 1, Florian Recker3, Evelyn Klein1,

Marion Kiechle1, Fabian Riedel4, Bastian Meyer1

1Frauenklinik Klinikum rechts der Isar, TU München, München, Deutschland

2Frauenklinik Friedrich–Alexander-Universität Erlangen–Nürnberg, Erlangen,

Deutschland

3Frauenklinik Universitätsklinikum Bonn, Bonn, Deutschland

4Frauenklinik Universitätsklinikum Heidelberg, Heidelberg, Deutschland

Background: Chat Generative Pre-Trained Transformer (ChatGPT) is an

articial learning and large language model tool developed by OpenAI

in 2022. Our study aimed to assess ChatGPT’s performance in medical

knowledge competency – particularly for problem assessment in obstet-

rics and gynecology (OB/GYN) – and to discuss possible applications.

Methods: For the analysis, two datasets were established: questions (1)

from OB/GYN course exams at a German university hospital and (2)

from the German medical state licensing exams. A quantitative analysis

compared the accuracy of ChatGPT’s answers with that of medical stu-

dents for dierent levels of diculty and types of questions. Additionally,

a qualitative analysis assessed the quality of ChatGPT’s responses. Non-

obvious insights generated by ChatGPT were evaluated, and a density

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts20

index of insights was established in order to quantify the tool’s ability to

provide relevant medical knowledge.

Result: ChatGPT demonstrated consistent performance across both data-

sets. It provided correct responses at a rate comparable with that of medical

students, thereby indicating its ability to handle a diverse spectrum of ques-

tions ranging from general knowledge to complex clinical case presenta-

tions. Our qualitative assessment revealed that ChatGPT provided mostly

accurate, complete, and relevant answers. ChatGPT additionally provided

many non-obvious insights, especially in correctly answered questions, which

indicates its potential for enhancing autonomous medical learning.

Discussion: ChatGPT has promise as a supplementary tool in medical

education. As AI technologies continue to evolve, ChatGPT and similar

tools may contribute to more ecient and personalized learning experi-

ences, thereby fostering inclusivity and accessibility.

Conclusion: ChatGPT’s ability to provide accurate and insightful

responses showcases its adaptability to complex clinical scenarios. is

may pave its way for further application in the clinical setting, for example

in clinical oncology.

Disclosure Statement: e authors declare no conict of interest.

462

KITTU: Articial intelligence supports multidisciplinary cancer

conferences – rst steps towards revolutionizing clinical

decision making in oncology

Gregor Duwe1; Verena Kauth1; Kerstin Moench1; Dominique Mercier2;

Markus Junker2; Juergen Scheele3; Werner Seiz3; Oliver Pfante3;

Juan Pablo Vesga Simmins3; Natasja De Bruin3; Axel Haferkamp1;

Andreas Dengel2; Thomas Höfner1,4

1Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Klinik und

Poliklinik für Urologie und Kinderurologie, Mainz, Deutschland

2Deutsches Forschungszentrum für künstliche Intelligenz GmbH - Zentrale,

Smarte Daten & Wissensdienste, Kaiserslautern, Deutschland

3Innoplexus AG, Translational Science, Eschborn, Deutschland

4Ordensklinikum Linz Elisabethinen, Klinik für Urologie, Linz, Österreich

Background: Decisions on the best available treatment in clinical oncol-

ogy are based on expert opinions in multidisciplinary cancer conferences

(MCC). e experts should provide unbiased recommendations based on

current guidelines and clinical studies. For this purpose, articial intelli-

gence (AI) could increase evidence-based treatment in oncology as assis-

tance system to give an additional treatment recommendation in MCC.

Methods: We have dened consecutive work steps to achieve this goal.

As a st step, we have transformed patient data of our urological MCCs

from 2015 - 2022 into representations that can be used in soware devel-

opment. Additionally, we have transformed relevant data from clinical

studies selected knowledge representation. Currently, soware routine

and rst AI neural network soware is developed.

Results: e collaborative project has successfully applied for a grant of 2.4

million euros from the German Federal Ministry of Education and Research

(BMBF, grant number: 16SV9053) to conduct this multidisciplinary research

together with international experts in AI development. KITTU will run from

August 2022 until July 2025. If the results of our dened working packages

are successful, we will start the technical integration into everyday clinical

practice based on a subsequent soware development study.

Discussion: With our alliance project “KITTU” (AI-supported treatment

support for cancer patients in urology) we aim to develop a pioneering AI

assistance system to generate additional treatment recommendations in

MCC. By the inclusion of study results within the machine learning pro-

cess we expect to provide an AI system that is explainable in its decisions

to support individual treatment decisions.

Conclusions: KITTU will be developed to support clinical decision mak-

ing in clinical oncology, beginning in genitourinary cancer. If successful, it

would revolutionize integration of knowledge from AI into genitourinary

oncology and could potentially be transferred to all types of oncological

treatments.

Disclosure Statement: e authors declare no conict of interest.

506

Exploring the potential of AI-powered applications for clinical

decision-making in gynecology

Bastian Meyer1; Katharina Känger1; Niklas Amann2; Florian Recker3;

Evelyn Klein1; Marion Kiechle1; Fabian Riedel4; Maximilian Riedel1

1Klinikum rechts der Isar, TU München, München, Deutschland

2Frauenklinik Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen,

Deutschland

3Frauenklinik Universitätsklinikum Bonn, Bonn, Deutschland

4Frauenklinik Universitätsklinikum Heidelberg, Heidelberg, Deutschland

Background: e rise of AI-powered platforms like ChatGPT heralds a

promising phase in medical innovation. Exhibiting remarkable prowess

in medical assessments, oen surpassing the performance of medical

students, these platforms oer considerable promise for revolutionary

applications in healthcare. is study seeks to investigate the viability of

employing ChatGPT for automated therapy recommendations by exam-

ining patient data, specically within the domain of gynecology.

Methods: Utilizing datasets comprising random patient information from

a university gynecological outpatient clinic and diverse scenarios from

gynecological tumor boards, we tasked ChatGPT with automated diagno-

sis and treatment suggestions. Expert gynecologists rigorously evaluated

the generated responses both qualitatively and quantitatively, comparing

them against actual clinical decisions.

Result: In the majority of outpatient scenarios, ChatGPT’s diagnoses were

in close agreement with clinical assessments, and the suggested therapies

received highly positive evaluations. Particularly noteworthy was the consen-

sus reached in therapeutic recommendations for both gynecological and seno-

logical cases presented in the context of tumor board scenarios. Nevertheless,

no additional benet was evident in relation to study inclusion, given that the

platform’s dataset was conned to information accessible until 2021.

Discussion: Our study extends upon existing knowledge of utilizing

AI-based applications such as ChatGPT in the eld of medicine. While

therapy recommendations for outpatient cases received favorable reviews,

the diverse results in tumor board scenarios reect the real-world intri-

cacies that demand discussions involving multiple experts. We highlight

both the advantages and constraints of the application in its present form.

Conclusion: Envisioning the ongoing incorporation of AI-powered solu-

tions in the medical realm, we foresee the potential for automated therapy

recommendations to support human clinical decisions in the future.

Disclosure Statement: e authors declare no conict of interest.

541

Feasibility of AI-based optimization of patient-physician

conversations

Chloë Goossens1,2,3; Lena Wurmthaler1,2,3; Lena Brückner1,2,3;

Manuel Hörner1,2,3; Matthias W. Beckmann1,2,3; Frederik Stuebs1,2,3;

Anna Lisa Zahn1,2,3; Peter Andreas Fasching1,2,3; Hanna Hübner1,2,3

1Bavarian Cancer Research Center (BZKF), Erlangen, Deutschland

2Department of Gynecology and Obstetrics, University Hospital Erlangen,

Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen,

Deutschland

3Comprehensive Cancer Center EMN, University Hospital Erlangen, Friedrich-

Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Deutschland

Background: Oncologists face the challenge of responding to patient needs

while making therapeutic decisions under time constraints. Patient-physician

communication can aect treatment decisions and patients’ quality of life.

Articial intelligence (AI) could help optimize individual patient-physician

communications and might aid medical decision-making.

Methods: Conversations between oncologists and breast cancer patients

were recorded, transcribed and evaluated by ChatGPT (language model

based on GPT-3.5 architecture by OpenAI) using 19 structured questions.

Questionnaires assessed the feasibility of recordings and acceptance of

AI-based conversation optimization and medical decision-making.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 21

Result: Between May 2021 and May 2023, 68 patients were enrolled in the

COMMITMENT study. 56 of 59 audio recordings were successfully tran-

scribed and 52 transcripts evaluated by ChatGPT. According to ChatGPT,

30 conversations (58%) could have been improved if the physician and

patient provided more specic information on symptoms and medication.

14 patients (27%) reported side eects when rst asked, while 16 patient

responses (31%) were deemed somewhat to moderately specic. Other

optimizable aspects included actively addressing patient concerns (56%;

N=29) and encouraging patient engagement (50%; N=26). 53 patients

(86%) found audio recording acceptable. 53% (N=33) agreed that AI

could make it easier for the physician to show interest in the patients’

needs and increase mutual attentiveness (45%; N=28). 43 patients (69%)

found that AI should not replace physicians in medical decision-making

and 77% (N=48) would always trust physicians over AI.

Discussion: AI identied optimizable aspects in patient-physician con-

versations. Patients perceived AI-based conversation optimization as

favorable and feasible, whereas AI-based medical decision-making was

viewed more critical.

Conclusion: AI-based optimization of patient-physician conversations

appears feasible and should be further investigated.

Disclosure Statement: e authors declare no conict of interest.

581

Krebs-Forschungsdatenzentrum – Konzeption,

Herausforderungen und Analysepotenzial des Linkage

versorgungsnaher Daten –

Olaf Schoer1; Kees Kleihues-van Tol2; Fabian Baum1; Bianca Franke2;

Vinzenz Völkel3; Stefan Rolf Benz4; Judith Hansinger3; Martin Lablans5;

Michael Gerken3; Daniel Maier6; Fabienne Fox6; Melanie Börries7;

Jörg Janne Vehreschild6; Tobias Kussel5; Soo-Zin Kim-Wanner8;

Jacqueline Witzmann2; Monika Klinkhammer-Schalke2,3; Jochen Schmitt1

1TU Dresden - Zentrum für Evidenzbasierte Gesundheitsversorgung (ZEGV),

Dresden, Deutschland

2Arbeitsgemeinschaft Deutscher Tumorzentren e. V., Berlin, Deutschland

3Universität Regensburg, Tumorzentrum Regensburg, Regensburg, Deutschland

4Arbeitsgemeinschaft Deutscher Darmkrebszentren (addz e.V.), Hamburg,

Deutschland

5Deutsches Krebsforschungszentrum (DKfZ), Heidelberg, Deutschland

6Johann Wolfgang Goethe Universität Frankfurt, Med. Klinik, Frankfurt am Main,

Deutschland

7Universitätsklinikum Freiburg, Institut für Medizinische Bioinformation und

Systemmedizin, Freiburg, Deutschland

8HLfGP - Hessisches Krebsregister, Frankfurt am Main, Deutschland

Background: e law on the pooling of cancer registry data denes a

framework for the nationwide synthesis of oncological treatment data.

Leading organizations and representatives of cancer registries are working

together to develop a platform solution. Since randomized controlled tri-

als are not equally suitable for all questions, guidelines for some questions

only contain recommendations with a limited level of evidence. Analyses

of health care data can close gaps and generate high-quality evidence.

erefore, the overall goal of the project Cancer Research Data Center

(onkoFDZ) is the development of an IT infrastructure that enables the

linkage of these data and tests the evidence generation on the basis of the

use case “therapy of colorectal cancer”.

Methods: Data from dierent care-related sources are integrated: Clinical

Cancer Registries (CCR), certied centers of the German Cancer Society

(DKG), German Consortium for Translational Cancer Research (DKTK)

and statutory health insurance (SHI). e data are comprehensively

cleaned, harmonized and linked on an occasion-related basis. Machine

learning (ML) methods will then be used to approximate treatment inten-

tions from documented treatment decisions. In addition, ML methods

will be compared with conventional statistical methods of data analysis.

Result: In the current initial phase of the project, concepts and study

documents for data ows and evaluation are being developed, taking into

account data protection requirements.

Discussion: Linking heterogeneous data from dierent sources is chal-

lenging, as it is subject to strict data protection requirements and requires

comprehensive harmonization.

Conclusion: e IT infrastructure developed in the project as a basis for

linking healthcare-related data from dierent sources will be implemented

sustainably and made available permanently to the scientic community

to enable AI-based generation of high-quality evidence.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

615

Creation of realistic synthetic cancer registry data

Mika Katalinic1; Jan Gaebel2; Matthäus Stöhr3; Martin Schenk4;

Stefan Franke5; Alexander Katalinic6; Thomas Neumuth2; Andreas Dietz3

1Universität Leipzig, Leipzig, Deutschland

2Innovation Center Computer Assisted Surgery (ICCAS), University Leipzig,

Leipzig, Deutschland

3Klinik und Poliklinik für Hals-, Nasen-, Ohrenheilkunde, Universitätsklinikum

Leipzig, Leipzig, Deutschland

4Innovation Center Computer Assisted Surgery, University Leipzig, Leipzig,

Deutschland

2Innovation Center Computer Assisted Surgery (ICCAS), University Leipzig,

Leipzig, Deutschland

6Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Deutschland

Background: Comprehensive cancer registry data has to be evaluated as

personal data, even when no names of patients, address or full birth date

are included. Risk of reidentication of patients by record linkage with other

data sources is high. So, data sharing might not always be possible, especially

when large, open science datasets are needed, as for AI development. For

such purposes synthetic data should be as realistic as possible, e.g., survival

analyses should lead to realistic gures. With our project we aimed to gener-

ate realistic cancer data with the use case of laryngeal cancer.

Methods: We used the open-source soware Synthea and programmed an

additional module for development, treatment and follow-up (5 years) of

laryngeal cancer (ICD 10: C32), using external, real-world (RW) evidence

from guidelines, cancer registries and literature for Germany. To gener-

ate an incidence-based cohort view, we randomly draw laryngeal cancer

cases from the simulated population and deceased persons, stratied by

the real-world age- and sex-distribution of laryngeal cancer at diagnosis.

Result: A Synthea module letting person fall sick with laryngeal cancer,

with age- and stage-specic treatment and prognosis could be successfully

implemented. e synthesized population reects RW prevalence quite

well. Extracting laryngeal cancer patients leads to a cohort of more than

10.000 laryngeal cancer patients. Descriptive data, as well as stage-specic

and overall 5-year survival, was in good agreement to published data.

Discussion: Using synthetic cancer patients, generated by Synthea, will

enable the creation of realistic and large (even larger than RW incidence)

cancer patient cohorts. Such data could be easily shared and published as

open source without any data protection issues.

Conclusion: Using the data for analyses will lead to realistic results,

whereas realism is limited by the amount of information included in the

module.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts22

735

Exploring Data-Based Machine Learning Algorithms for the

Evaluation of Disease Stage, Treatment-response and Overall

Survival in Pancreatic adenocarcinoma

François Schneider1; Haotian Chen2; Richard G. Compton2;

Uwe Pelzer1; Gregor Duwe3; Sebastian Stintzing1; Ulrich Keilholz4;

Christopher Neumann1

1Medizinische Klinik mit Schwerpunkt Onkologie und Hämatologie der Charité

Campus Mitte, Berlin, Deutschland

2Department of Chemistry, Physical and Theoretical Chemistry Laboratory,

Oxford University, Oxford, United Kingdom

3Department of Urology and Pediatric Urology, University Medical Center of the

Johannes-Gutenberg University Mainz, Mainz, Deutschland

4Charité Comprehensive Cancer Center, Berlin, Deutschland

Background: Articial Intelligence (AI) and in particular the eld of

Machine Learning is gaining more and more importance in Medicine and

Clinical Oncology. Data-based AI algorithms can identify unknown cor-

relations of multiparametric matrices and have great potential for devel-

oping novel digital-based predictive and prognostic biomarkers.

Methods: First, we implemented the Random Forest Classier and Gradient

Boosting Classier. In order for these Classies to be trained, we used our

patient database, including all patients diagnosed with PDAC at the Charité

- Universitätsmedizin Berlin between 2009 and 2021. As one of the largest

monocentric databases, this comprised a total of 2.323 patients. e dataset

was randomly divided into a training and applied/tested dataset. By using

trained AI-algorithms to our applied dataset, the accuracy of our models was

evaluated. e results were visualized by ROC curves.

Result: Random Forest and Gradient Boosting Classiers were performed

on our dataset including clinical and laboratory data of patients with

PDAC. Both classiers showed high accuracy in predicting the 3- and

5-year-survival rate (> 84.6%, ROC AUC 0.72). Moreover, AI-algorithms

were able to predict whether PDAC patients were metastasized with an

accuracy as high as 80.3% (ROC AUC 0.76). By implementing a binary

classication of the two chemotherapeutic regimens mFOLFIRINOX vs.

Gemcitabine/nab-Paclitaxel, an accuracy > 80.0% was achieved.

Discussion: e results of this study illustrate that both Random Forest

and Gradient Boosting are eective classiers for predictability power

in Clinical Oncology. Further more complex AI-algorithms will need to

be implemented, not only accounting for the clinicial data but also the

image-analyses of radiological datasets.

Conclusion: e present study contributes to the evaluation of

AI-algorithms for predicting disease stage, treatment-response and

overall survival in PDAC patients.

Disclosure Statement: e authors declare no conict of interest.

758

The modied Polsby-Popper score is a novel quantitative

histomorphology biomarker with potential to predict

lymph node positivity and cancer-specic survival in tongue

squamous cell carcinoma

Tamás Dániel Csűry1,2,3; Anna Zsóa Csűry4; Matthias Balk1,2,3;

Andreas M. Kist5; Robin Rupp1,2,3; Sarina Müller1,2,3; Matti Sievert1,2,3;

Heinrich Iro1,2,3; Markus Eckstein1,3,6; Antoniu-Oreste Gostian1,2,3

1Comprehensive Cancer Center EMN, University Hospital Erlangen,

Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Deutschland

2Department of Otolaryngology, Head & Neck Surgery, University Hospital

Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen,

Deutschland

3Bavarian Cancer Research Center (Bayerisches Zentrum für Krebsforschung,

BZKF), Erlangen, Deutschland

4individual contributor, Mechelen, Belgien

5Department Articial Intelligence in Biomedical Engineering, Friedrich-

Alexander-Universität Erlangen-Nürnberg, Erlangen, Deutschland

6Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander-

Universität Erlangen-Nürnberg, Erlangen, Deutschland

Background: e signicance of dierent histological tumor spreading

patterns in tongue squamous cell carcinoma (TSCC) is well known. We

constructed a numeric parameter, i.e. the modied Polsby-Popper (MPP)

score, reecting the aggressiveness of tumor spread to analyze hematoxy-

lin and eosin-stained whole slide images (WSIs) in an automated manner.

We investigated the application of the MPP score in predicting survival

and cervical lymph node metastases as well as in determining patients at

risk in the context of dierent surgical margin scenarios.

Methods: We developed a semi-automated image analysis workow to

detect tumorous areas of the WSIs. Perimeter and area of the detected

regions were derived, and a mathematical formula was applied to reect

the perimeter/area ratio in a comparable manner across WSIs. We

demonstrated the plausibility of the MPP score by correlating it with well-

established pathological parameters. We then performed survival analysis

to assess the relevance of the MPP score with an emphasis on dierent

surgical margin scenarios. Machine learning models were developed to

predict survival and occult cervical metastases.

Results: e MPP score was associated with unfavorable tumor spread.

Higher MPP scores were associated with worse overall survival and tongue

carcinoma-specic survival (TCSS), both when assessing all pT-categories

and pT1-pT2 categories only. Higher MPP scores were associated with

a worse TCSS where a cancer-free surgical margin of <5 mm could be

achieved. e MPP score could successfully dene patients at risk of distant

metastasis in pT1-pT2 cancer. Machine learning (ML) models including the

MPP score could predict the 5-year TCSS eciently and those that predict

occult cervical lymph node disease benetted from including the MPP score.

Conclusion: We introduced an objective and observer-independent

parameter, the MPP score, representing the aggressiveness of tumor

spread in TSCC. We showed its prognostic relevance especially in

pT1-pT2 TSCC and its use in ML models predicting TCSS and occult

cervical metastases.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 23

782

Decipher patient needs in the process of genetic counseling to

individualize the personal assistant GENIE

Beate Vajen1; Nils Ammon1; Chiara Reichert2; Steen Oeltze-Jafra2;

Schlegelberger Brigitte1; Anke Katharina Bergmann1; Thomas Kupka2;

Dominik Wol2

1Medizinische Hochschule Hannover/Institut für Humangenetik, Hannover,

Deutschland

2Medizinische Hochschule Hannover/Peter L. Reichertz Institut für Medizinische

Informatik, Hannover, Deutschland

Background: Genetic counseling is a central element in the care of

patients and families with hereditary breast and ovarian cancer (HBOC).

Index patients and their families receive a wealth of information, about

the nature of the disease, preventive measures, therapy options, support

services such as psycho-oncological care. We develop the mobile assistant

GENIE to support patients in the genetic counseling process in a person-

alized way. For the personalization, we rst determined patient needs with

qualitative interviews.

Methods: To determine patients’ needs, nine qualitative interviews were

conducted in 10/2022 with HBOC patients, who presented for genetic

counseling and testing at the Department of Human Genetics (2017-

2022) of Hanover Medical School. Six women suered from breast cancer

while three women had no cancer diagnosis. e qualitative evaluation

was performed using Mayring’s content analysis.

Result: Although the interpersonal interaction between human geneti-

cists and patients was reported as a positive experience, patients noted

that 1) the timing of counseling was oen inconvenient, 2) a second

genetic counseling would be helpful, 3) there was a need for support in

collecting own and familial medical information before the genetic coun-

seling session, 4) the assistance in contacting self-help groups and psy-

cho-oncologists could be enhanced, 5) the density of medical information

was excessively high.

Discussion: Our ndings reveal a signicant demand among HBOC

patients for improved personalized support. Interestingly, patients

increasingly requested supportive information regarding medical genetics

not only aer genetic counseling but also before it.

Conclusion: e results contribute to the development of a patient-

centered support tool designed to assist patients before and aer genetic

counseling takes place. e implementation of AI-based mobile support

for HBOC patients will improve their self-ecacy and health literacy

while alleviating their burden.

Disclosure Statement: e authors declare no conict of interest.

838

Roboscreen: an automated, multiparameter 3D diagnostic

platform for personalized cancer therapy

Barbara Mayer1; Marlene Niederreiter1; Jan Rael2; Victoria Scharin3;

Marco Flachmann3; Martin Gutbrod4; Petra Mela2

1Department of General, Visceral and Transplantation Surgery, LMU University

Hospital, LMU Munich, München, Deutschland

2Technical University of Munich, München, Deutschland

3Opto GmbH Munich, München, Deutschland

4PreSens Precision Sensing GmbH, Regensburg, Regensburg, Deutschland

Background: Currently, the selection of personalized therapies for indi-

vidual cancer patients is primarily based on single outcome measure-

ments. However, single-assay systems poorly reect the complexity of

tumors, resulting in limited predictive power of drug testing.

Methods: To overcome this obstacle, the Roboscreen project introduced

an automated platform that integrates imaging, sensing, metabolomics,

and machine learning. is multi-parameter system is used for drug

screening in the patient-derived cancer spheroid model (PDCS).

Result: A platform consisting of three interactive units was devel-

oped: automated production of high-content PDCS models, automated

label-free, real-time imaging, and automated high-resolution pH and

O2 sensing. Given these parameters, PDCS can be screened for optimal

treatment time points. e system runs under standardized incubator

conditions.

Discussion: Manual preparation of PDCS models, followed by man-

ual pipetting of drugs and endpoint measurements for drug ecacy, is

a time-consuming, error-prone workow. Integrative automation of this

multi-step process is a prerequisite for standardization, reproducibility,

scalability, and timesaving. Automated drug screening is particularly

advantageous for large tumor samples and high-throughput analyses.

However, in biopsies, tumor material is lost due to machine dead vol-

ume. In addition, dierent processing protocols are required to cope with

tumor heterogeneity and complexity.

Conclusion: e automated, multi-parametric 3D diagnostic platform

is a prerequisite for comprehensive and standardized personalization of

cancer therapy and drug development.

Disclosure Statement: Authors BM, MHN, JP, and PM declare no conict

of interest. Authors MF and VS are employees of Opto GmbH and MG is an

employee of PreSens Precision Sensing GmbH.

Disclosure Statement: e authors declare the following: Firmeninteresse.

851

AI to fully automate detection of tumor budding in head

and neck cancer

Iordanis Ourailidis1,2; Albrecht Stenzinger1; Peter Schirmacher1;

Wilko Weichert3; Fabian Stögbauer3; Melanie Boxberg3; Jan Budczies1

1Pathologisches Institut, Universitätsklinikum Heidelberg, Heidelberg,

Deutschland

2Faculty of Biosciences, Heidelberg University, Heidelberg, Deutschland

3Institut für Pathologie, Technische Universität München, München,

Deutschland

Background: Tumor budding (TB), referring to clusters of up to four

tumor cells detached from the tumor bulk, is highly prognostic for poor

patient survival and associates with lymph node mestastasis in head and

neck squamous cell carcinoma (HNSCC)1. TB is detected in histopatho-

logical hematoxylin/eosin-stained (HE) slides via a laborious, time con-

suming process. us, it is of great importance to enable a fast, accurate

and standardized way of detection of TB patterns. Achieving this goal can

be mediated by developing an automated method for TB detection.

Methods: 70 randomly selected TCGA HNSCC HE whole-slide images

(WSI) of budding cases were tiled, annotated by pathologists and used

for training and validation (80% and 20% respectively), while 252 TCGA

HNSCC HE WSIs constituted the test dataset (TD). Using YOLOv52, a

single-pass CNN-based object detector, we developed a custom bud

detector for rapid assessment of TB. Our detector’s results were compared

to TB scores obtained by the pathologists1.

Result: e TB estimation of the bud detector and the pathologists are

highly correlating (Pearson’s R=0.8, p<10-15, TD). Our detector could sep-

arate the high and low budding cases [with AUC=0.85 (0.8-0.9), p<10-15,

TD] and show that tumor budding leads to worse survival rates [HR=1.6

(1.1-2.3), p<0.02, TD].

Discussion: TB detection methods have been developed for other can-

cer entities, mostly colorectal cancer3. However, to our knowledge this is

the rst fully automated tumor bud detector for HNSCC. Our automated

TB detector can alleviate the prognostic stratication of HNSCC patients,

improving clinical management and follow-up.

Conclusion: We demonstrate that fully automated tumor bud detection

and TB assessment using HE WSIs is feasible in HNSCC, can be achieved

fast with low computational power and facilitates prognostic stratication

of patients. e applicability of our TB detector should be tested in daily

clinical practice.

1. Stögbauer F et al., Br J Cancer. 2023;128(12) 2295.

2. Jocher G, Ultralytics YOLOv5. 7.0, 2020.

3. Bokhorst, JM et al., Mod Pathol. 2023;36(9) 100233.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts24

Disclosure Statement: e authors declare the following: JB and MB: funding by

the German Cancer Aid (grants 70113973 and 70113976). JB: consulting fees by

MSD. MB: consulting fees by BMS. AS: grants by Bayer, BMS, Chugai, and Incyte.

AS: Advisory Boards/Speaker’s Bureau: Agilent, Aignostics, Amgen, Astra Zeneca,

Bayer, BMS, Eli Lilly, Illumina, Incyte, Janssen, MSD, Novartis, Pzer, Qlucore,

Roche, Seagen, Takeda, ermo Fisher. PS: funding by Roche, Chugai, BMS,

Novartis. PS: Advisory Board/Speaker’s Bureau: Astra Zeneca, Incyte, Janssen.

891

When time is of the essence – ethical implications of XAI in

surgical oncology

Andreas Wabro; Markus Herrmann

NCT Heidelberg, Section Translational Medical Ethics, Heidelberg, Deutschland

Purpose: Explainable articial intelligence (XAI) has the potential to pro-

vide valuable intraoperative decision support, likely augmenting surgical

judgment, anticipating adverse events, and facilitating further treatment

planning while retaining trust through transparency. In surgical oncol-

ogy, XAI could improve decision-making by reducing surgery times and

unfavorable outcomes. Despite increasing calls for XAI on regulatory lev-

els, inherent properties of surgical environments, such as time pressure

and economic eciency, are most oen le unnoticed. e aim of this

paper is to discuss the application of XAI in time-sensitive environments

of surgical oncology, and to provide an ethical assessment of clinicians’

accountability for their decisions reached.

Methods: We conducted a series of expert interviews with academic

researchers currently in charge of designing XAI decision support sys-

tems. We used a questionnaire created by including relevant aspects of

ethics guidelines provided by supranational institutions.

Results: We identied relevant ethical implications to be further dis-

cussed in the context of surgical oncology. XAI could facilitate intraoper-

ative evaluation of resection margins, predict stitching patterns, and assess

blood perfusion of anastomoses, among other types of benecial appli-

cations. Yet, time-pressure constraints of surgical environments could

essentially deter surgeons to properly consider the respective explanatory

output. Additionally, requiring XAI in time-sensitive environments could

counteract initial reasons for deploying the decision support system at

hand.

Discussion: ese ndings have strong implications regarding the ascrip-

tion of accountability, for psychological traits and time pressure con-

straints could alter the decision-making capacity of clinicians in such

contexts.

Conclusions: In surgical oncology, time-sensitive environments require

more dierentiated views of XAI and human accountability. ey ignite

calls for increased metacognitive activities of clinicians involved.

Disclosure Statement: e authors declare no conict of interest.

913

Application of deep neural networks for the detection of

bladder cancer: a feasibility study using a domain transfer

Philipp Maisch1; Thomas Wittenberg2,3; Thomas Eixelberger2;

Sebastian Belle4; Stephan Kruck5; Maximilian Kriegmair6; Christian Bolenz1

1Klinik für Urologie und Kinderurologie, Universitätsklinikum Ulm, Ulm,

Deutschland

2Fraunhofer-Institut für Integrierte Schaltungen IIS, Erlangen, Deutschland

3Lehrstuhl für Graphische Datenverarbeitung, FAU Erlangen, Erlangen,

Deutschland

4Klinik für Gastroenterologie der Universitäts-Medizin Mannheim, Mannheim,

Deutschland

5Klinik für Urologie, Siloah St. Trudpert Klinikum, Pforzheim, Deutschland

6Urologische Klinik München-Planegg, München, Deutschland

Background: In order to increase the detection rate of bladder cancer

(BCa) during white-light cystoscopy and transurethral resection, meth-

ods such as photodynamic diagnosis or narrow band imaging have been

developed in recent years. e application of articial intelligence (AI)

using deep neural networks (NN) may improve the detection rate of BCa.

Methods: Initially, a NN with a YOLOv7-tiny architecture for real-time

object detection was iteratively trained on > 35,000 white-light colono-

scopic images with suspicious lesions. e classication rate of this NN

has a precision = 0.92, a sensitivity = 0.90 and a F1 value = 0.91. For our

multicenter study, 406 cystoscopic individual images (n = 117 patients)

with lesions and 251 negative ndings (normal urothelium), as well as

19 cystoscopic video sequences were prospectively recorded. All lesions

presented in the data were annotated and veried by urology specialists.

Result: All cystoscopic images were analyzed with the NN. An ad hoc detec-

tion of suspicious lesions in the urinary bladder was possible in the majority

of the ndings. Based on the cystoscopic image data, the NN provided a pre-

cision = 0.82, a sensitivity = 0.77 and F1 value = 0.79. Due to the YOLOv7-

tiny architecture, single images could be processed within 17 to 20 ms.

Discussion: is feasibility study indicates that the proposed domain

transfer approach (from colonoscopy to cystoscopy), with additional

images from cystoscopy, is viable to create a model for detecting BCa in

real time. Satisfactory detection rates for suspicious lesions were already

evident in the early phase of this study.

Conclusion: e methodology presented could accelerate the spread of

AI in the context of “enhanced cystoscopy”. It may be conceivable that the

presented domain transfer approach could also be used in other areas of

diagnostics, e.g., sonography.

Disclosure Statement: e authors declare no conict of interest.

Biomarker

352

6th Nationwide Tumor-biological Testing Survey in Patients

with NSCLC in Germany – Current Results and Development of

Testing Behavior since 2012

Sonja Loges1,2,3; Bärbel Söhlke4; Helmut Ostermann5

1DKFZ-Hector Cancer Institute, University Medical Center Mannheim,

Mannheim, Deutschland

2Division of Personalized Medical Oncology (A420), German Cancer Research

Center (DKFZ), Heidelberg, Deutschland

3Department of Personalized Oncology, University Hospital Mannheim,

Medical Faculty Mannheim, University of Heidelberg, Mannheim, Mannheim,

Deutschland

4zielGENau e. V., Köln, Deutschland

5LMU University Hospital, München, Deutschland

Background: Personalized drug therapy following assessment of molec-

ular alterations in tumor tissue has become standard-of-care in stage IV

NSCLC. Also neoadjuvant and adjuvant treatment options in early stage

NSCLC require biomarker testing. We determine whether testing in

Germany is performed as per guideline recommendations, which foresee

companion diagnostics guided drug therapy from which many patients

benet considerably.

Methods: ~100 Experienced oncologists from dierent types of health

care institutions (lung cancer centers, university/ non-university hospi-

tals, oce-based physicians) are asked to answer a questionnaire on the

details of testing. Data are analyzed by explorative analysis and compared

with previous data from 2012 to 2023.

Result: As previous surveys from this group have shown, biomarker

testing in early stage NSCLC is going to be established in Germany with

increasing testing rates until today. In late stage NSCLC established

marker like EGFR, PD-L1, ALK, ROS are on a plateau level, however test-

ing rates of other biomarkers are much behind with testing rates of ~60%

and below. e results of the new survey which is currently ongoing will

clarify whether important improvements in testing rates have occurred

over the past 2 years.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 25

Discussion: Overall there is still potential for improvement in Germany

in terms of the optimal use of therapy options. As most of the participated

institutions are now expected to be certied as lung cancer centers and/

or associated with network associations like nNGM we will investigate

whether this corresponds to an increase in guideline adherence.

Conclusion: In Germany many lung cancer patients still do not have

access to comprehensive molecular diagnostics and adequate personal-

ized therapy. In order to close the substantial gap between the potential

use of molecularly stratied therapies and the reality of care and to pro-

vide targeted therapy to as many eligible patients as possible, testing rates

of molecular markers in NSCLC must continue to increase.

Disclosure Statement: e authors declare the following: is study was

supported by AstraZeneca.

524

Impact of liquid biopsy preanalytics on cfDNA fragmentation

analyses

Ariane Hallermayr1,2,3; Thomas Keßler1,3; Courtney König1,3;

Selina Gisinger1; Verena Steinke-Lange1,2,3; Elke Holinski-Feder1,2,3;

Inés Aznar-Peralta4,5; M. Jose Serrano4,6; Carmen Carmen Garrido-Navas4,6

1MGZ – Medizinisch Genetisches Zentrum, Munich, Deutschland

2Medizinische Klinik und Poliklinik IV, Campus Innenstadt, Klinikum der

Universität München, Munich, Deutschland

3European Liquid Biopsy Society, Hamburg, Deutschland

4Centro Pzer - Universidad de Granada - Junta de Andalucía Centre for

Genomics and Oncological Research (GENYO), Granada, Spanien

5Biochemistry and Molecular Biology Doctoral Programe, Universidad de

Granada, Granada, Spanien

6IBS Granada, Institute of Biomedical Research. Avenida de Madrid 15, Granada,

Spanien

Background: Recent studies indicate the potential of the untargeted

detection of lowest levels of circulating tumor DNA (ctDNA) based on

fragmentation analysis of total circulating free DNA (cfDNA). Here, we

performed a pilot study to evaluate the impact of preanalytics on cfDNA

fragmentomics.

Methods: Blood samples from 10 healthy individuals and 3 patients with

metastatic colorectal cancer (CRC) were collected in citrate tubes at the

partner site in Granada. To investigate the impact of sample shipping and

cfDNA isolation on cfDNA fragmentation, cfDNA was isolated using

manual and automated extraction methods. e eects of dierent prea-

nalytical workows on sensitivity and specicity of fragmentation-based

ctDNA detection were evaluated using the whole-genome sequencing

(WGS)-based LIquid biopsy Fragmentation, Epigenetic signature, and

Copy Number Alteration analysis (LIFE-CNA), previously developed by

the partner site in Munich.

Result: Plasma cfDNA concentration in samples collected from healthy

individuals in citrate tubes was signicantly higher than in the panel of

normals with blood samples collected in Streck tubes (p-value < 0.05). e

dierent isolation methods did not result in signicantly dierent plasma

cfDNA concentrations. With LIFE-CNA, no major dierences regarding

the analyzed parameters, such as cfDNA fragmentation and chromatin

signatures, were observed to be dependent on the preanalytical.

Discussion: Within our pilot study we showed that neither dierences in

sample collection tubes nor dierences in cfDNA isolation workows had

a signicant impact on cfDNA fragmentation analysis. ese preliminary

results suggest that cfDNA samples shipped across Europe can be used for

fragmentation-based ctDNA detection.

Conclusion: In the framework of our collaboration we will initiate a larger

study to investigate the performance of targeted and fragmentation-based

ctDNA analysis for the early detection of CRC in a larger cohort of early

and late-stage patients.

Disclosure Statement: e authors declare no conict of interest.

545

Clinical relevance of pre-treatment testing to identify

DPD-decient patients at increased risk of severe toxicity

Panoraia Arni1; Michael Stahl1; Alexander Traut2

1Internistische Onkologie und Onkologische Palliativmedizin, Evang. Kliniken

Essen-Mitte, Essen, Deutschland

2Klinik für Gynäkologie und Gynäkologische Onkologie, Evang. Kliniken

Essen-Mitte, Essen, Deutschland

Background: e German Oncology Societies have endorsed the recom-

mendation of the European Medicines Agency (EMA) that all patients

(pts) should be tested for DPD deciency prior to systemic treatment with

uoropyrimidines (FP). Despite having treated approximately 150 pts per

year, about 1 pt per year had to be treated for severe toxicities that would

have indicated a relevant reduction in DPD activity. erefore, the organ-

isational and nancial burden of DPD testing in all pts prior to the FP use

should be questioned.

Methods: All pts with gastrointestinal carcinoma receiving rst-line FP

from June 2020 until May 2021 were included. ere were 2 groups, pts

with and without DPD testing. DPD testing was only performed if a delay

in therapy pending the test result was justied. Pts from both groups were

selected for statistical comparison using matched-pair analysis. e pri-

mary endpoint was the occurrence of serious toxicities leading to hospi-

talisation or treatment-related death. Secondary endpoints were toxicities

I-II° CTC and III-IV° CTC.

Result: Of the 164 pts studied, 119 were tested for DPD deciency and

45 were not. A DPD mutation (haplotype B3, heterozygous) was detected

in 6 of the pts (5.0%) in the tested group. Emergency hospitalisation was

required in 24 pts (20.2%) in the tested group versus 12 pts (26.7%) in the

non-tested group. Treatment-related death occurred in 4 pts (3.4%) in the

tested group versus 2 pts (4.2%) in the group without test (p>0.05). 53

pts (44.5%) in the tested group experienced toxicity I-II° CTC (stomatitis,

diarrhea, leucopenia, HFS) versus 16 pts (35.6%) in the non-tested group.

29 pts (24.4%) versus 19 pts (42.2%) experienced grade III-IV° CTC tox-

icity in the group with and without test, respectively.

Discussion: Clinical parameters (age, line of treatment, FP monotherapy

or in combination) relevant to treatment toxicity should also be evaluated.

Conclusion: In our retrospective analysis, there was no signicant dif-

ference between the two groups in prevention of serious toxicities and

consecutive need for hospital admission.

Disclosure Statement: e authors declare no conict of interest.

616

THSD7A is a potential biomarker in prostate cancer and in

squamous cell carcinoma of the lung

Fidelis Flockerzi; Phillip Stahl

Department of Pathology, Saarland University Medical Center, Homburg/Saar,

Deutschland

Background: In a former study we were able to show that rombospondin

Type-1 Domain containing 7A (THSD7A)-overexpression is associated

with unfavorable prognostic parameters in prostate cancer and with PSA

recurrence. Furthermore, several other studies indicate that THSD7A

might at least play a role in the prognosis of dierent tumor types.

ere is also evidence that Focal Adhesion Kinase (FAK) might be acti-

vated by THSD7A. We aimed to examine the role of THSD7A as a poten-

tial biomarker in prostate cancer and squamous cell carcinoma of the lung

(LSCC). In addition, we analyzed the impact of THSD7A-positivity on the

expression level of FAK in its unphosphorylated form.

Methods: Expression status of THSD7A and FAK were analyzed by

immunohistochemistry (IHC) using tissue microarrays (TMA) (n=461

prostate cancer samples, n=101 lung cancer samples).

Results: In prostate cancer, THSD7A-positivity was signicantly asso-

ciated with unfavorable prognostic parameters. In addition, THSD7A-

positivity was signicantly associated with high FAK-expression. In

LSCC, THSD7A-positivity was associated with poor overall survival in

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts26

the subgroup of female patients. THSD7A-positivity at least showed a

tendency towards high FAK-expression in this subgroup.

Discussion: To our knowledge, we are the rst to show that THSD7A-

positivity is signicantly associated with high FAK expression in pros-

tate cancer and at least shows a tendency towards high FAK-expression

in female patients with LSCC. Furthermore, THSD7A positivity predicts

poor overall survival in female patients with LSCC and is associated with

unfavorable prognostic parameters in prostate cancer.

Conclusion: Our results might be a proof of the assumed activation of

FAK-dependent signaling pathways by THSD7A. THSD7A is a membrane-

associated protein and therefore must be discussed as a putative therapeutic

target in prostate cancer and squamous cell carcinoma of the lung.

Disclosure Statement: e authors declare no conict of interest.

660

Prevalence of clinically relevant established and emerging

biomarkers in mNSCLC in a German study cohort

Stefanie Schatz; Markus Falk; Stefanie Schmidt; Markus Tiemann

Institut für Hämatopathologie, Hamburg, Deutschland

Background: New targeted and immune therapies are available or

expected to be approved in Europe for metastatic NSCLC including

HER2 directed ADCs, KRAS G12C specic targeted therapies or double

IO/chemo combinations. We evaluated real-world frequency of predic-

tive/prognostic alterations in light of these therapies, including the genes

EGFR, HER2, KRAS and STK11 as well as KRAS/STK11 co-mutations.

Methods: We retrospectively analyzed 700 NSCLC samples from our

internal documentation system of 2022. All specimens were sequenced

by hybrid capture NGS, based on the Agilent XTHS2 chemistry and the

Illumina NextSeq 500 sequencing platform. Histological and mutation

subtypes were evaluated.

Result: Adenocarcinomas (N=546) carried 40.8% (N=223) KRAS muta-

tions (N=95 KRAS G12C). Inactivating STK11 mutations were present

in 16.1% of cases (8.3% KRAS co-mutated) followed by activating EGFR

(12,8%) and activating HER2 mutations (0.7%) plus 1.1% HER2 ampli-

cations (CNV). In non-adenocarcinomas (N=154) we found 1,9% (N=3)

activating EGFR and 8.4% (N=13) KRAS mutations, however no KRAS

G12C.

Discussion: We analyzed the frequency of relevant alterations that may

serve as predictive/prognostic biomarkers to current and upcoming ther-

apies in a real-world setting. While KRAS and STK11 mutated subgroups

have been associated with a worse outcome, data from clinical trials like

POSEIDON indicate that KRAS and STK11 mutated subgroups may ben-

et from double IO/chemo combinations. KRAS constituted the most

common driver alteration and was highly co-mutated with STK11. HER2

as a potential target rarely carried activating mutations.

Conclusion: With new indications on the horizon for metastatic NSCLC,

it is important to understand frequency of molecular drivers and the

impact of co-mutations on targeted and IO treatment. In the molecular

pathological report it is critical to clearly decipher pathogenic variants

from those with unknown clinical signicance.

Disclosure Statement: e authors declare the following: is study was

supported by AstraZeneca.

775

Assessing the immunological consequence of metastatic

potential- linking MACC1 and immune evasion

Sebastian Torke; Reyhan Rose Divarci; Wolfgang Walther; Ulrike Stein

Experimental and Clinical Research Center, Charité - Universitätsmedizin Berlin

and Max-Delbrück Centrum, Berlin, Deutschland

Background: Metastasis formation is the most lethal attribute of cancer,

critically limiting survival and therapeutic options. To improve patient

outcomes, knowledge on targetable markers, representing causal driv-

ers of metastasis, is essential. Our laboratory has identied metastasis

associated in colon cancer 1 (MACC1), a driver of metastasis in more

than 20 cancer entities. One prerequisite for metastasis is the evasion of

immune response. While MACC1 is central in many processes of cancer

progression, how it regulates immune evasion is poorly understood.

Methods: Using cells with low (SW480), moderate (HCT116) and high

(SW620) endogenous MACC1 expression, and transgenic variants with

MACC1 overexpression or knockout, we analyzed the expression of

immunologically relevant markers. Furthermore, we assessed how tumor

intrinsic MACC1 expression aects the activation of T cells and T cell-me-

diated tumor cell killing using live cell imaging.

Result: MACC1 induces CD95 (Fas), a death receptor that possesses

various tumor-promoting functions. e immune checkpoints (IC)

PD-1 and PD-L1 were increasingly expressed in cells with high MACC1.

Stimulating T cells with conditioned medium from MACC1-high tumor

cells decreased the expression of CD95 and CD69, highlighting a reduced

activation. In a co-culture we observed that MACC1 expression protected

tumor cells from T cell-mediated killing.

Discussion: Taken together, we report that MACC1 mediates mechanisms

of immune escape. Currently, we are using cyclic immunouorescence on

patient-derived tissues to analyze the distribution of immunologically rel-

evant markers in dependence to MACC1. Especially the spatial resolution

of tumor–immune cell interactions as well as IC expression in regard to

MACC1 will provide novel insight into immune evasion strategies utilized

by tumor cells.

Conclusion: Overall, we aim to establish the relevance of MACC1 in

the interaction of tumor and immune cells. is knowledge enables us

to assess immunotherapies in a clinical context relevant to the individual

metastatic risk.

Disclosure Statement: e authors declare no conict of interest.

779

SARIFA, a new prognostic histomorphological biomarker in

gastric cancer identies cases with a distinct biology – a post

hoc analysis of the ST03 trial

Bianca Grosser1; Stefan Schiele1; Nic Reitsam1; Jake Emmerson2;

David Cunningham3; Matt Nankivell4; Ruth Langley4; William Allum5;

Martin Trepel6; Bruno Märkl7; Heike Grabsch8

1Pathology, Medical Faculty Augsburg, University of Augsburg, Augsburg,

Deutschland

2Leeds Institute of Clinical Trials Research, University of Leeds, Leeds,

Deutschland

3Department of Medicine, Royal Marsden Hospital, Sutton, Surrey, United

Kingdom

4Medical Research Council Clinical Trials Unit at University College London,

London, United Kingdom

5Department of Oncology and Department of Surgery, Royal Marsden NHS

Foundation Trust, London, United Kingdom

6Department of Internal Medicine II, Hematology and Oncology, Medical

Faculty Augsburg, University of Augsburg, Augsburg, Deutschland

7Pathology, Medical Faculty Augsburg, University of Augsburg, Augsurg,

Deutschland

8Department of Pathology, GROW School for Oncology and Reproduction,

Maastricht University Medical Center+, Maastricht, Niederlande

Background: Recently, we dened SARIFA as a new histomorphological

biomarker in GI cancers by the occurrence of stroma areactive invasion

front areas with at least ve tumor cells with direct contact with adipo-

cytes. Data from basic research indicate a switch toward lipid metabolism

caused by this interaction.

Methods: We analyzed digitalized H&E-stained slides of 640 patients. In

contrast to the original denition, where we assumed SARIFA positivity

beginning from a singular area with ve cells, we investigated a poten-

tial quantitative eect. Based on the percentage of histological slides with

SARIFA-positive areas, SARIFA has been stratied into four (negative,

low, intermediate, high) or three categories (negative, low, high), respec-

tively. Log-rank tests and Cox proportional hazard models have been cal-

culated for overall survival.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 27

Result: SARIFA-positivity was found in 322 (50%), cases and proved to be

a strong negative prognostic biomarker. Moreover, a quantity-dependent

eect could be determined with HRs of HRs of 1.00, 2.48, 2.74 and 3.72

for the 4-tiered system and 1.00, 1.86, 2.79 for the 3-tiered system, respec-

tively. Even, the SARIFA-low group was associated with an adverse out-

come. Moreover, this prognostic eect was signicant independently from

other established risk factors (pT, pN, R-status, Chemotherapy).

Discussion: We could demonstrate a quantity-dependent eect of

SARIFA in gastric cancer. Importantly, the survival dierence between

SARIFA-negative and -low cases is much stronger compared to the dif-

ference between the two or three SARIFA-positive groups, respectively.

is indicates a strong biological mechanism behind this morphological

phenomenon that holds true even in cases with low frequency. Based

on previous data, we suggest a distinct tumor biology driven by lipid

metabolism.

Conclusion: SARIFA is a strong prognostic marker with a quantitative

eect. However, even a low frequency is linked with such a strong power

that a two-tiered system is recommended.

Disclosure Statement: e authors declare no conict of interest.

793

Immunocytochemistry Proling of Circulating Tumor Cells for

Accurate Determination of mTOR and ARv7 Expression Status

Stefan Schuster1; Felix Melchior1; Dadasaheb Akolkar2; Darshana Patil2

1Datar Cancer Genetics Europe GmbH, Bayreuth, Deutschland

2Datar Cancer Genetics Limited, Nashik, Indien

Background: Clinical decisions including selection of anticancer agents

are oen based on biomarker status on tissue samples. Tumor tissue insuf-

ciency and heterogeneity along with tumor evolution as well as acquired

resistance necessitate the need to look for liquid biopsy-based evaluation.

We present the performance of a circulating tumor cells (CTCs) based test

to determine the expression of mammalian target of Rapamycin (mTOR)

in various cancers and androgen receptor v7 (ARv7) in prostate cancer.

Methods: Tumor tissue samples and matched pre-biopsy blood samples

were obtained from 62 patients with breast (n = 29), lung (n = 19) or

prostate (n = 14) cancers. Tumor derived cells and CTCs were collected

from tumor tissue and blood samples respectively1 and proled by immu-

nocytochemistry to determine status of mTOR in breast and lung cancers

and ARv7 in prostate cancer.

Result: Concordance rates of mTOR in breast cancer were 66.67% (posi-

tive, n = 3), 100% (negative, n = 26), and 96.6% (overall, n = 29). In lung,

concordance rates were 100% for both, positive (n = 11) and negative

(n=8), cases with an overall rate of 100% (n = 19). e combined results

for mTOR in breast and lung were 92.9% (positive, n = 14), 100% (neg-

ative, n = 34), and 97.9% (overall, n = 48). For prostate (n = 14), CTC

analysis of ARv7 demonstrated 100% sensitivity (positive, n = 4) and 80%

specicity (negative, n = 10). CTCs were notably eective in detecting

acquired resistance related to ARv7.

Discussion: e allure of blood-based methods lies in their inherent

accessibility. Amidst CTC-driven techniques, achieving comparability has

posed a substantial hurdle as some methods have failed do demonstrate

clinical relevance. Yet, our approach reconrms CTCs’ signicant treat-

ment contribution. e congruence between mTOR and ARv7 expression

on CTCs and tumor tissue underscores their reliable potential.

Conclusion: Our study strengthens the value of CTC based biomarker

testing in clinical settings as a viable alternative to tissue-based testing.

Reference:

1 Crook T et al. DOI: 10.1007/s00280-020-04189-8.

Disclosure Statement: e authors declare the following: S.S. and F.M. are

employed at Datar Cancer Genetics Europe GmbH, Bayreuth, Germany, and P.V.

and D.P. are employed at Datar Cancer Genetics Ltd., Nasik, India, both together

focusing on new diagnostic solutions in oncology.

858

Liquid biopsy in colorectal cancer - Beyond the targeted

analysis of single variants

Ariane Hallermayr1,2,3; Tobias Wohlfrom1; Verena Steinke-Lange1,2,3;

Anna Benet-Pagès1,4; Florentine Scharf1; Ellen Heitzer3,5,6,7;

Ulrich Mansmann8; Christopher Haberl9; Maike de Wit10,11;

Holger Vogelsang12; Markus Rentsch13,14; Elke Holinski-Feder1,2,3;

Julia MA Pickl1,2

1MGZ – Medizinisch Genetisches Zentrum, Munich, Deutschland

2Medizinische Klinik und Poliklinik IV, Campus Innenstadt, Klinikum der

Universität München, Munich, Deutschland

3European Liquid Biopsy Society, Hamburg, Deutschland

4Institute of Neurogenomics, Helmholtz Zentrum München - German Research

Center for Environmental Health, Neuherberg, Deutschland

5Institute of Human Genetics, Diagnostic and Research Center for Molecular

Biomedicine (Austria), Medical University of Graz, Graz, Österreich

6BioTechMed-Graz, Graz, Österreich

7Christian Doppler Laboratory for Liquid Biopsies for Early Detection of Cancer,

Graz, Österreich

8Institute for Medical Information Processing, Biometry, and Epidemiology–IBE,

LMU Munich, Munich, Deutschland

9Department of Oncology and Hematology, Barmherzige Brüder, Klinikum St.

Elisabeth, Straubing, Deutschland

10Department of Hematology, Oncology and Palliative Medicine, Vivantes

Klinikum Neukoelln, Berlin, Deutschland

11Department of Oncology, Vivantes Auguste-Viktoria-Klinikum, Berlin,

Deutschland

12Department of General, Visceral, Thoracic and Endocrine Surgery, Klinikum

Garmisch-Partenkirchen, Teaching Hospital, Ludwig Maximilian University

Munich, Garmisch-Partenkirchen, Deutschland

13Department of General, Visceral and Thorax Surgery, Klinikum Ingolstadt,

Ingolstadt, Deutschland

14Department of General, Visceral, Vascular and Transplant Surgery, University

Hospital Munich, Ludwig-Maximilians University of Munich, Campus

Großhadern, München, Deutschland

Background: e main focus in liquid biopsy diagnostics is on circulat-

ing tumor DNA (ctDNA) analysis, targeting actionable hotspot variants

to guide treatment decisions. We developed a whole-genome sequencing

(WGS)-based approach for untargeted ctDNA analysis providing a prom-

ising tool for real-time monitoring of cancer patients.

Methods: We established LIquid biopsy Fragmentation, Epigenetic signa-

ture and Copy Number Alteration analysis (LIFE-CNA) using WGS with

~6x coverage in 259 plasma samples collected from healthy individuals

and colorectal cancer (CRC) patients.

Result: Using 55 healthy controls, we established distinct cutos for the

detection of ctDNA based on global and regional fragmentation patterns,

transcriptionally active chromatin and somatic copy number alterations.

is enabled the accurate prediction of ctDNA in 81% of patients with

localized and in 94% of patients with metastatic disease at the time of pri-

mary diagnosis. By adding a machine learning classier to our workow,

which combines global and regional cfDNA fragmentation, we were able

to increase the accurate prediction of ctDNA presence (93% of patients

with localized and 94% of patients with metastatic disease at diagnosis).

By following individual patients throughout their course of disease, we

observed that changes in ctDNA signals reliably predicted response or

progression up to 5 months prior to clinical manifestation in 77% or 100%

of patients, respectively.

Discussion: We developed and validated a sensitive and cost-eective

method for untargeted ctDNA detection at the time of diagnosis or recur-

rence, as well as for treatment monitoring, expanding the advantages of

liquid biopsy.

Conclusion: Our approach is applicable to a wide range of cancer patients,

and with minor adjustments in the bioinformatics analysis, LIFE-CNA

could be easily extended to all tumor entities. e high sensitivity and

cost-eectiveness of our approach form the basis for the implementation

of LIFE-CNA into clinical practice.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts28

Breast Cancer

Tucatinib in patients with locally advanced or metastatic

HER2-positive breast cancer who received at least two prior

anti-HER2 treatment regimens: Study design of the

non-interventional study TRACE in Germany and Austria

Arnd Nusch1; Moritz Angerer2; Manfred Welslau3; Christoph Uleer4;

Julia Radosa5; Denise Wrobel6; Stefanie Noeding7; Klaus Apel8;

Jürgen Terhaag9; Ingo Tamm10; Lelia Bauer11; Marija Balic12; Daniel Egle13;

Nadia Harbeck14; Volkmar Müller15; Eva Schumacher-Wulf16;

Rebecca de Buhr17; Martin Glasstetter17; Johanna Hanselmann17;

Cathrin Hogrefe17; Norbert Marschner17; Katja Gratze17; Rupert Bartsch18;

Anja Welt19

1Praxis für Hämatologie und Onkologie, Ratingen, Deutschland

2Schwerpunktpraxis Hämatologie & Internistische Onkologie, Fürth,

Deutschland

3MVZ am Klinikum Aschaenburg GmbH, Aschaenburg, Deutschland

4Praxisgemeinschaft Gynäkologische Onkologie & spezielle oparative

Gynäkologie, Hildesheim, Deutschland

5Universitätsklinikum des Saarlandes, Homburg (Saar), Deutschland

6Sozialstiftung Bamberg Klinik für Frauenheilkunde und Geburtshilfe, Bamberg,

Deutschland

7Dr. Stefanie Noeding, Gynäkologie & medikamentöse Tumortherapie, Siloah

Krankenhaus // Haus K, Hannover, Deutschland

8Dr. Apel Medizinische Versorgung GmbH, Erfurt, Deutschland

9Frauenärzte am Schellenbruckplatz MVZ Eggenfelden GbR, Eggenfelden,

Deutschland

10Onkologische Schwerpunktpraxis Kurfürstendamm, Berlin, Deutschland

11GRN-Klinik Weinheim, Weinheim, Deutschland

12LKH-Univ. Klinikum Graz, Graz, Österreich

13Medizinische Universität Innsbruck, Innsbruck, Österreich

14Klinikum der Universität München, München, Deutschland

15Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland

16Mamma Mia – Die Krebsmagazine, atp Verlag GmbH, Köln, Deutschland

17iOMEDICO AG, Freiburg im Breisgau, Deutschland

18Medizinische Universität Wien, Wien, Österreich

19Universitätsklinikum Essen, Essen, Deutschland

Background: Tucatinib (TUC), a highly selective HER2 tyrosine kinase

inhibitor, combined (comb.) with trastuzumab (TRAS) + capecitabine

(CAPE), demonstrated a signicant overall and progression-free survival

benet compared to placebo + TRAS + CAPE1, 2 in the HER2CLIMB

trial and has been approved in Europe for HER2+ advanced breast can-

cer (ABC) patients (pts) aer ≥ 2 prior anti-HER2 therapies. TRACE will

collect real-world (rw) data of TUC + TRAS + CAPE according (acc.)

to SmPC, including pts underrepresented or excluded from the pivotal

trial like elderly pts or pts treated with TUC in early ABC treatment lines.

Moreover, data on TUC combination therapy (TH) aer prior TH with

TRAS-Deruxtecan will be gathered.

Methods: is non-interventional trial will document up to 300 HER2+

ABC pts scheduled to receive TUC + TRAS + CAPE acc. to SmPC in 60

German & 10 Austrian sites. 150 pts each (up to 30 Austrian pts each)

will be enrolled into the 1st/2nd & 3rd/4th line cohorts. Primary endpoint

is time to deterioration of patient-reported global quality of life (QoL)

in EQ-5D-5L, EORTC QLQ-C30, and QLQ-BR23 questionnaires.

Descriptive statistics will be used to analyze changes in the functional and

symptom sub-scores compared to baseline, as well as eectiveness (e.),

safety, physician decision making, details on TUC treatment, TH manage-

ment, and treatment sequences.

Result: n.a.

Discussion: n.a.

Conclusion: TRACE will provide important rw insights into treatment

with TUC + TRAS + CAPE for HER2+ ABC pts with focus on QoL, e.

and safety. Preplanned subgroup analyses will ll important knowledge

gaps between the pivotal trial and routine clinical practice.

Indication of source:

1 Murthy RK et al: Tucatinib, trastuzumab, and capecitabine for HER2-positive

metastatic breast cancer. N Engl J Med 382(7): 597–609, 2020.

2 Curigliano G et al: Tucatinib versus placebo added to trastuzumab and

capecitabine for patients with pretreated HER2+ metastatic breast cancer with

and without brain metastases (HER2CLIMB): nal overall survival analysis.

Ann Oncol 33(3): 321–329, 2022.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

A Randomized Controlled Trial of Argentine Tango to Improve

Cancer-Related Fatigue and Quality of Life in Breast Cancer

Survivors

Jessica Groß1, Shiao LI Oei2, Anja Thronicke2, Thomas Rieser2,3,

Sarah Becker1, Patricia Grabowski4,5, Gerrit Grieb6, Harald Matthes2,3,

Friedemann Schad2,4

1Brustzentrum, Gemeinschaftskrankenhaus Havelhöhe, Berlin, Deutschland

2Forschungsinstitut Havelhöhe, am Gemeinschaftskrankenhaus, Berlin,

Deutschland

3Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité –

Universitätsmedizin Berlin, Berlin, Deutschland

4Onkologisches Zentrum, Interdisziplinäre Onkologie und Palliativmedizin

Gemeinschaftskrankenhaus Havelhöhe, Berlin, Deutschland

5Institut für Medizinische Immunologie, Charité – Universitätsmedizin Berlin,

Berlin, Deutschland

6Plastische Chirurgie und Handchirurgie, Gemeinschaftskrankenhaus

Havelhöhe, Berlin, Deutschland

Background: Persistent impairments of health-related quality of life

(QoL), in particular cancer-associated fatigue, are major limitations for

cancer survivors. As physical activity and mindfulness interventions have

been shown to be eective, we investigated the ecacy of a six-week

Argentine Tango program on QoL outcomes of breast cancer survivors.

Methods: A randomized controlled trial was conducted with 60 breast

cancer survivors diagnosed with stage I-III tumors 12-48 months prior to

study enrollment and who had increased symptoms of fatigue. e partic-

ipants were randomly assigned with a 1:1 allocation to either the Tango or

the Waiting group. e Tango program consisted of six weekly one-hour

group sessions. Using the EORTC QLQ C30 and the German version of

the Cancer Fatigue Scale QoL parameters were assessed and additionally

pre-post analysis of QoL changes, also 6 and 12 months thereaer were

performed and compared with a historical control cohort of 108 breast

cancer survivors.

Result: A total of 52 participants completed the Tango and Waiting assess-

ments. Superiority of the Tango intervention over the Waiting list control

was found in terms of improvement in fatigue (d = -0.64; 95%CI, -1.2 to

-0.08; p = 0.03), especially cognitive fatigue. A pooled pre-post analysis

of the 50 participants completing the six-week Tango program revealed a

close to 10% improvement of fatigue (p = 0.0003), insomnia (p = 0.008)

and further QoL outcomes. Aer six months, signicant improvements in

fatigue (p=0.006), physical functioning (p=0.01), and diarrhea (p=0.04)

were still detectable in the Tango participants, but not in the control

cohort.

Discussion: is randomized controlled trial is the rst ecacy study

demonstrating that a Tango program improved fatigue and QoL in breast

cancer survivors and that this improvement persisted for at least six

months.

Conclusion: Meanwhile, exercise, moderate resistance training, and

physical activity are part of international oncology guidelines, and these

may be expanded to include dance.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 29

A real-world prospective observational multi-national study

in adult patients with breast cancer treated with extended

adjuvant neratinib: NERLYFE study

Dirk-Toralf Baerens1; Nadia Harbeck2; Apurna Jegannathen3;

Baschar Youssef4; Hossam Abdulkhalek5; Mark Davies6; Martin Smakal7;

Martina Zimovjanova8; Marcus Schmidt9; Farida Beghdad10;

Marta Zivanov10; Rupert Bartsch11

1Gemeinschaftspraxis für Gynäkologie, Ilsede/Groß Ilsede, Deutschland

2Comprehensive Cancer Center of the Ludwig-Maximilians-University, Breast

Center, Department of Gynecology and Obstetrics, Munich, Deutschland

3University Hospitals of North Midlands NHS Trust Stoke-on-Trent, Department

of Oncology, Staord, United Kingdom

4Städtische Kliniken Mönchengladbach, Brustzentrum, Mönchengladbach,

Deutschland

5Western Health and Social Care Trust, Altnagelvin Hospital, North West Cancer

Centre, Londonderry, United Kingdom

6Singleton Hospital, Swansea, Sketty, Swansea, United Kingdom

7Onkologicke Oddelení, Nemocnice Horovice, Horovice, Tschechische Republik

8Charles University, General Hospital Prague, Department of Oncology, Prague,

Tschechische Republik

9University Medical Center Mainz, Mainz, Deutschland

10Pierre Fabre, Boulogne Billancourt, Frankreich

11Medical University of Vienna, Clinical Research Unit Division of Oncology

Department of Medicine I, Wien, Österreich

Background: Neratinib is an oral pan-HER TKI approved in Europe

in adult patients with early-stage HR+ HER2+ breast cancer who com-

pleted adjuvant trastuzumab-based therapy ≤ 1 year ago. In the phase III

ExteNET study, neratinib demonstrated an iDFS advantage of 5.1% at 5

years in the HR+/HER2+ population. Without mandated antidiarrheal

prophylaxis the most common AE reported was diarrhoea (39% grade 3).

Methods: NERLYFE is a post-authorization safety study (PASS), investi-

gating real-world incidence and management of diarrhoea with neratinib.

368 patients will be enrolled in Austria, Czech Republic, Germany, and

the United Kingdom. Eligible patients will be assigned to receive extended

adjuvant neratinib as indicated in the SmPC and having received educa-

tional materials.

e primary objective is to characterize the incidence of permanent

discontinuation due to diarrhoea ≤3 months of neratinib treatment.

Secondary objectives will characterize diarrhoea patterns, treatment

maintenance, the impact of treatment-related diarrhoea on QoL, and

the eectiveness of the educational materials by patients and physicians.

To gather information on cancer recurrence, an ancillary protocol will

describe clinical outcomes at 2 years (iDFS, DDFS, CNS events, OS). e

follow-up of patients is planned from treatment initiation until 24 months.

Result: As of 24/07/2023, 44 sites in four European countries enrolled 51

patients. Final study results are expected in 2026.

Discussion: n.a.

Conclusion: In a real-world setting in Europe, this study will further

characterize neratinib-related diarrhoea in patients with early breast can-

cer treated with extended adjuvant neratinib. It will also assess the eec-

tiveness of the educational materials. e ancillary study will describe

clinical outcomes at 2 years.

Funding: e study is funded by Pierre Fabre. First published: St. Gallen 2023

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

HER2-Low expression in primary male breast cancer

Christian Rudlowski1; Melanie Erices-Leclercq1; Katleen Nobbe1;

Stephan Baldus2; Robert Förster3; Frank Förster4; Sabine Lubig1

1EVK, Bergisch Gladbach, Deutschland

2Institut für Pathologie und Zytopathologie, Bergisch Gladbach, Deutschland

3Institute for Radiation Oncology, Cantonal Hospital Winterthur, Winterthur,

Schweiz

4MVZ für Gynäkologische Onkologie und Palliativmedizin, Poliklinik GmbH,

Chemnitz, Deutschland

Background: Female breast cancer (FBC) expressing low levels of HER2

oers new treatment options with antibody-drug-conjugates. No evidence

was found that HER2-Low describes a new FBC subtype with specic

tumorbiological features and impact on survival. Studies are lacking to

determine the impact of HER2-Low in male breast cancer (MBC). Here,

we evaluate the prevalence of HER2-Low in primary MBC and correlate

the results with clinicopathologic features and outcome.

Methods: In this retrospective study histological specimens were obtained

from 120 male patients who were diagnosed and treated for primary inva-

sive breast cancer from 1995 to 2022 at Breast Cancer Units in Bergisch

Gladbach, Chemnitz and Zwickau, Germany. HER2 staining was per-

formed by central pathology and evaluated in accordance with the 2023

ASCO guidelines. HER2-Low expression was statistically correlated with

tumorbiological characteristics and patients outcome.

Results: 77 (64.2%) of cases were HER2 negative (HER2 0), 7 (5.8%) were

HER2 2+ (ISH negative), 32 (26.7%) were HER2-Low (1+). Four patients

(3.3%) showed HER2 positivity (3+). One patient was triple negative. Out

of the 77 HER2 negative cases 47 tumors (61.0%) show an incomplete

staining with < 10% of tumor cells classied as HER2 ultralow. No statis-

tical correlation between HER2-Low and tumorbiological characteristics

and patients survival was demonstrable.

Conclusion: Our ndings demonstrate a remarkable but lower prevalence

of HER2-Low expression in primary MBC compared to FBC. However,

HER2-Low expressing tumors show no specic tumorbiological fea-

tures to dene a new breast cancer subtype in MBC. Further studies are

required to better understand HER2-Low breast cancer in general and in

particular in MBC.

Disclosure Statement: e authors declare no conict of interest.

135

Evaluation of the age limits in the German mammography

screening program

Theresa Hunger; Elke Nekolla; Eva Wanka-Pail; Katharina Stella Winter;

Gunnar Brix

Bundesamt für Strahlenschutz, Oberschleißheim, Deutschland

Background: e German mammography screening program (MSP)

invites asymptomatic women aged 50–69 years to biennial breast cancer

screening. Increased life expectancy and European guidelines gave reason

to reassess the age limits. e Federal Oce for Radiation Protection has

the legal mandate to evaluate radiological screening examinations and

make recommendations to the Federal Ministry for Nature, Environmental

Protection, Nuclear Safety and Consumer Protection on their admissibility.

Methods: Benets and harms of mammography screening in women

under 50 and over 70 years of age were assessed in a systematic literature

review. e radiation risk was estimated on the basis of established radia-

tion epidemiological models, which were adapted to the German popula-

tion. Current exposure data were applied.

Result: ere is evidence from eight randomized controlled trials (RCT)

that mammography screening in women under the age of 50 can reduce

breast cancer mortality by about 18% (risk ratio (RR)=0.82; 95%-con-

dence interval (CI): 0.71–0.96). For women aged 70–74 years, evidence

from RCT is limited but also indicates a reduction of breast cancer mortal-

ity (RR=0.72; 95%-CI: 0.54-0.95). Radiation exposure in mammography

screening is low and the associated risk for women screened beyond the age

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts30

of 70 years is only marginally higher compared to current screening practice.

However, screening at ages 40–69 or ages 45–69 has an about 2-fold or

50% higher radiation associated excess lifetime risk, respectively, com-

pared to screening at ages 50–69.

Discussion: While more women could benet from the German MSP

when extending the age limits, older women have a higher risk of overdi-

agnosis due to competing death risks and lower remaining life expectancy,

and younger women face a higher radiation risk from screening.

Conclusion: From a radiation protection perspective and under the

aspect of preventing opportunistic screening, extending the age limits to

45–75years in the German MSP with the given high-quality standards is

justied.

Disclosure Statement: e authors declare no conict of interest.

175

Final analysis of the placebo-controlled randomised phase

3 IMpassion031 trial evaluating neoadjuvant atezolizumab

(atezo) plus chemotherapy (CT) followed by open-label

adjuvant atezo in patients (pts) with early-stage triple-

negative breast cancer (eTNBC)

Nadia Harbeck1; Carlos Barrios2; Amy Zhang3; Shigehira Saji4; Kyung Hae

Jung5; Roberto Hegg6; Andreas Köhler7; Joo Hyuk Sohn8; Hiroji Iwata9;

Melinda Telli10; J.-F. Boileau11; Kevin Punie12; Max Dieterich13; Zoe Assaf14;

Trista Xu15; Mario Liste Hermoso13; Esther Shearer-Kang16; Luciana

Molinero14; Stephen Chui17; Elizabeth Mittendorf18

1Breast Center, Department of Gynecology and Obstetrics and Comprehensive

Cancer Center, Ludwig-Maximilians-University Hospital, München, Deutschland

2Latin American Cooperative Oncology Group (LACOG), Oncoclínicas, Porto

Alegre, Brasilien

3Department of Pathology, Memorial Sloan Kettering Cancer Center, New York,

NY, USA

4Medical Oncology, Fukushima Medical University, Fukushima, Japan

5Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republik

Korea

6Gynecological Clinical Service School of Medicine, University of São Paulo,

São Paulo, Brasilien

7Haematologie und Onkologie, Gemeinschaftspraxis für Haematologie und

Onkologie Langen, Langen, Deutschland

8Yonsei Cancer Center, Yonsei University Health System, Seoul, Republik Korea

9Breast Oncology Dept., Aichi Cancer Center Hospital, Nagoya, Japan

10School of Medicine, Stanford University, Stanford. CA, USA

11Jewish General Hospital, McGill University, Montréal, QC, Canada

12Department of General Medical Oncology and Multidisciplinary Breast Centre,

Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgien

13Product Development Oncology, F. Homann-La Roche Ltd, Basel, Schweiz

14Oncology Biomarker Development, Genentech, South San Francisco, CA, USA

15Data and Statistical Sciences – Oncology, Homann-La Roche Limited,

Mississauga, ON, Canada

16Product Development Safety, Genentech, South San Francisco, CA, USA

17Product Development Oncology, Genentech, South San Francisco, CA, USA

18Department of Surgery, Dana-Farber Brigham Cancer Center, Boston, MA, USA

Background: IMpassion031 (NCT03197935) met its primary objective,

signicantly improving pathological complete response (pCR) rate with

atezo added to neoadjuvant CT in pts with eTNBC (58% vs 41% with

CT alone in the intent-to-treat [ITT] population; 17% dierence, 1-sided

p=0.0044) [Mittendorf 2020]. Benet from atezo was seen regardless of

PD-L1 status. We here present the nal analysis of IMpassion031.

Methods: Pts with untreated stage II/III eTNBC and a primary tumour

>2 cm were randomised 1:1 to placebo or atezo 840 mg q2w + neoadju-

vant CT (nab-paclitaxel 125 mg/m2 qw for 12 wk, then doxorubicin 60

mg/m2 + cyclophosphamide 600 mg/m2 q2w for 8 wk). Aer surgery, pts

randomised to atezo received open-label atezo 1200 mg q3w for 11 cycles.

Pts without pCR could have standard adjuvant systemic therapy (± atezo).

Stratication factors were disease stage (II vs III) and PD-L1 status (IC

<1% vs ≥1% by SP142). Secondary ecacy endpoints included event-free

survival (EFS), disease-free survival (DFS) and overall survival (OS) in the

ITT and PD-L1+ populations.

Results: Aer ~39 mos’ median follow-up, EFS, DFS and OS numerically

favoured atezo vs placebo consistently across key clinical subgroups (HR

(95% CI) for ITT population: EFS, 0.76 (0.47-1.21); DFS, 0.76 (0.44-1.30);

OS, 0.56 (0.30-1.04). Among pts without pCR, 14/70 (20%) in the atezo

arm vs 33/99 (33%) in the placebo arm received additional adjuvant sys-

temic therapy, most oen capecitabine (4/70 [6%] vs 26/99 [26%]). In

exploratory analyses, pCR was highly prognostic for long-term outcome.

Exploratory ctDNA analyses showed clearance in most pts at surgery.

Positive ctDNA at/aer surgery was associated with poor prognosis. ere

were no new safety signals or treatment-related deaths with atezo.

Conclusion: e signicant pCR benet with the addition of atezo to CT

for eTNBC translated into numerically improved EFS, DFS and OS. Long-

term safety results are consistent with previous reports.

Previously presented at ESMO-BC, LBA1, Carlos Barrios et al. - Reused with

permission.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

182

ELECTRA: An open-label, multicenter, phase 1b/2 study of

elacestrant in combination with abemaciclib in patients with

brain metastasis from estrogen receptor-positive (ER+),

HER2-negative (HER2-) breast cancer (BC)

Erika Hamilton1; Sung-Bae Kim2; Ahmad Awada3; Nancy Lin4; Sebastian

Züe5; Simona Scartoni6; Bartomeu Piza Vallespir7; Kathy Puyana Theall7;

Nuhad Ibrahim8

1Sarah Cannon Research Institute/Tennessee Oncology, Nashville, USA

2Asan Medical Center, Seoul, Republik Korea

3Jules Bordet Cancer Institute, Brussels, Belgien

4Dana-Farber Cancer Institute, Boston, USA

5Klinikum Worms, Worms, Deutschland

6Menarini Group, Florence, Italien

7Stemline Therapeutics/Menarini Group, New York, USA

8MD Anderson Cancer Center, Houston, USA

Background: Currently, there are no approved systemic treatment

options for patients (pts) with ER+/HER2- BC and brain metastasis.

e prevalence of brain metastases from ER+/HER2- BC is ~14% of

women (Aversa, 2014). Elacestrant is a next-generation oral SERD that

was evaluated in the pivotal phase 3 EMERALD trial, where elacestrant

demonstrated signicantly prolonged PFS vs SOC endocrine therapy in

pts with ER+/HER2− ESR1 mutated mBC following progression on prior

endocrine therapy (Bidard, 2022). Elacestrant was well tolerated with a

manageable safety prole. Most adverse events, including nausea, were

low-grade and consistent with other endocrine therapies. A clinical study

in healthy postmenopausal women demonstrated the ability of elacestrant

to cross the blood-brain barrier (Conlan, 2020). Abemaciclib, a CDK4/6i,

has been shown to achieve therapeutic concentrations in brain metasta-

ses tissue (Tolaney, 2020). Given the lack of current systemic treatments,

elacestrant is now being evaluated with abemaciclib in patients with ER+/

HER2- BC and brain metastasis.

Methods: ELECTRA (NCT05386108) is an open-label phase 1b/2, mul-

ticenter study evaluating elacestrant in combination with abemaciclib,

eligibility are in patients with ER+/HER2− locally advanced or mBC and

measurable brain metastasis. For phase 1b, the presence of brain metasta-

ses are allowed but not required for eligibility. For phase 2, patients must

have ≥ 1 active and measurable brain metastais per RECIST v1.1. Patients

must have received prior therapy in the metastatic setting, including ≥ 1

endocrine therapy, ≤ 2 chemotherapy regimens, and 0-2 prior CDK4/6i

(excluding abemaciclib). e Phase 1b primary objective is to determine

the recommended phase 2 dose; secondary objectives include safety, PK,

ORR, DoR, CBR, PFS, and OS. e phase 2 primary objective is ORR per

RECIST version 1.1; secondary objectives include intracranial response

rate, DoR, CBR, PFS, OS, PK, and quality of life. Recruitment is actively

ongoing.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 31

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

191

Retrospective single case reports on the treatment of

patients with HER2-positive/HR-positive early breast cancer

withneratinib

Dagmar Guth1; Thomas Göhler2; Jörg Bäsecke3; Nils Tribian4;

Corinne Vannier5; Nicolai Maass4; Edgar Petru6

1Gynäkologisch-onkologische Praxis Dr.Guth, Plauen, Deutschland

2Onkozentrum Dresden, Dresden, Deutschland

3St. Josefs-Hospital Cloppenburg, Abteilung Hämatologie, Onkologie und

Palliativmedizin, Cloppenburg, Deutschland

4Universitätsklinikum Schleswig-Holstein, Campus Kiel, Klinik für Gynäkologie

und Geburtshilfe, Kiel, Deutschland

5Pierre Fabre Pharma GmbH, Freiburg, Deutschland

6Medizinische Universität Graz, Klinische Abteilung für Gynäkologie,

Graz, Österreich

Background: Neratinib is an oral, irreversible pan-HER TKI approved in

Europe in adult patients (pts) with early-stage hormone receptor positive

(HR+), HER2-positive (HER2+) breast cancer (BC) who completed adju-

vant trastuzumab-based therapy ≤1 year ago. In the phase III ExteNET

study, neratinib showed a signicant 5-year invasive disease-free survival

advantage (Δ5.1%, HR 0.58, 95% CI 0.41-0.82). Without mandated antid-

iarrheal prophylaxis, which is now routinely used in clinical practice, the

most common AE was diarrhea (39% grade 3).

Methods: is project aims to collect 25 retrospective single case reports

of adult pts with HER2+/HR+ early BC treated with neratinib for ≥3

months. It is conducted in up to 25 sites in Germany and Austria. Pts

are selected by the treating physicians according to 5 prespecied case

types (5 pts each) reecting relevant treatment situations, all followed by

extended adjuvant treatment with neratinib:

1. Adjuvant Trastuzumab (T)

2. Adjuvant T+Pertuzumab (P)

3a. pCR aer neoadjuvant T+P, T postneoadjuvant

3b. pCR aer neoadjuvant T+P, T+P postneoadjuvant

4. non-pCR aer neoadjuvant T+P, T-DM1 postneoadjuvant

Eligible pts with signed informed consent are documented in standard-

ized case report forms. e objective is to collect real-world data on nera-

tinib-containing anti-HER2 regimens with focus on neratinib treatment

management.

Result/Current Status: As of August 31, 2023, 8 sites are participating

or agreed to participate in the project in Germany (6 sites) and Austria

(2 sites). End of case report documentation is expected by mid-2024.

Conclusion: is project describes real-world treatment journeys of pts

with eBC treated with extended adjuvant neratinib including patients pre-

treated with the most recent trastuzumab based therapies. e collected

data could serve as basis for medical educational materials and scientic

discussions.

Funding: Study funding by Pierre Fabre.

First published: DGHO 2023

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

196

Long-term Patient-reported Outcomes from monarchE:

Abemaciclib plus Endocrine Therapy for Adjuvant HR+,

HER2−, Node-positive, High-risk, Early Breast Cancer

Nadia Harbeck1; Valentina Guarneri2; Jae Hong Seo3; Josena Cruz4;

Miguel Henriques Abreu5; Masato Takahashi6; Carlos Barrios7;

Kristi Mcintyre8; Ran Wei9; Belen San Antonio9; Astra M Liepa9;

Miguel Martin10; Stephen R.D. Johnston11; Sara M. Tolaney12

1Breast Centre, Department of Gynaecology and Obstetrics, Comprehensive

Cancer Centre München, LMU University Hospital, München, Deutschland

2Instituto Oncologico Veneto IRCCS, Padua, Italien

3Korea University Guro Hospital, Seoul, Republik Korea

4Hospital Universitario de Canarias, Canary Islands, Spanien

5Department of Medical Oncology, Portuguese Institute of Oncology of

Porto, Porto, Portugal

6National Hospital Organization Hokkaido Cancer Center, Hokkaido, Japan

7Hospital São Lucas da PUCRS, Porto Alegre, Brasilien

8Texas Oncology PA, Texas, USA

9Eli Lilly and Company, Indianapolis, USA

10Hospital General Universitario Gregorio Marañon, Universidad Complutense,

CIBERONC, GEICAM, Madrid, Spanien

11Royal Marsden NHS Foundation Trust, London, United Kingdom

12Dana-Farber Cancer Institute, Boston, USA

Background: Abemaciclib demonstrated sustained benet in inva-

sive disease-free survival and a tolerable safety prole in monarchE at

42months (mo) median follow-up (mFU). At 19mo mFU initial patient

(pt)-reported outcome (PRO) ndings supported a tolerable prole with

most remaining on treatment (tx). With all pts now o abemaciclib, we

report data including the full 2year tx period and follow-up to evaluate

long-term impact on PROs.

Methods: Pts completed PROs (FACT-B, FACT-ES, FACIT-Fatigue) at

baseline, 3, 6, 12, 18, 24mo and 1, 6, 12mo aer tx discontinuation (dc).

Mixed eects repeated measures model estimated changes from base-

line within and between arms for summary scores and individual items.

Meaningful change was 0.5 standard deviation of baseline summary

scores and 1 point for individual items. Additional analyses: frequencies

of responses to items associated with adverse events (AEs; eg, diarrhea,

fatigue) and tx bother.

Result: PRO completion rates (5591 treated pts) were >90% on tx and

~80% during follow-up. Within- and between-arms, dierences in mean

changes from baseline for all PROs were less than prespecied thresh-

olds for meaningful dierence, except for diarrhea, with worse scores in

abemaciclib+ET at 3 and 6mo. During tx most pts reported being both-

ered “a little bit” or “not at all” by side eects in both arms and most pts

(79-85%) on abemaciclib reported “not at all” to “somewhat” for diarrhea.

PROs in both arms (post-tx follow-up) were similar to baseline, with

≥80% of pts on abemaciclib arm reporting “not at all” for diarrhea.

Discussion: Adjuvant abemaciclib added to ET did not result in meaning-

ful dierences in PROs, except for diarrhea, which is considered clinically

manageable.

Conclusion: Long-term ndings suggest reversibility of these eects aer

tx dc and can help inform pt risk/benet assessment.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts32

214

ELEVATE: A phase 1b/2, open-label, umbrella study evaluating

elacestrant in various combinations in women and men with

estrogen receptor-positive (ER+), HER2-negative (HER2-)

locally advanced or metastatic breast cancer (mBC)

Hope S. Rugo1; Aditya Bardia2; Javier Cortes3; Giuseppe Curigliano4,5;

Erika Hamilton6; Sara A. Hurvitz7; Sibylle Loibl8,9; Sherko Kümmel10,11;

Simona Scartoni12; Shannon Matheny13; Kathy Puyana Theall13;

Joyce O’shaughnessy14

1University of California San Francisco Comprehensive Cancer Center,

San Francisco, USA

2Massachusetts General Hospital Cancer Center, Harvard Medical School,

Boston, USA

3International Breast Cancer Center, Quiron Group, Barcelona, Spanien

4European Institute of Oncology IRCSS, Milan, Italien

5University of Milano, Milan, Italien

6Sarah Cannon Cancer Institute/Tennessee Oncology, Nashville, USA

7UCLA Jonsson Comprehensive Cancer Center, Los Angeles, USA

8German Breast Group, Neu-Isenburg, Deutschland

9Centre for Haematology and Oncology Bethanien, Frankfurt, Deutschland

10Charité – Universitätsmedizin Berlin, Department of Gynecology with Breast

Cancer, Berlin, Deutschland

11Kliniken Essen-Mitte, Essen, Deutschland

12Menarini Group, Florence, Italien

13Stemline Therapeutics/Menarini Group, New York, USA

14Baylor University Medical Center, Texas Oncology, US Oncology, Dallas, USA

Background: Endocrine therapy (ET) is the mainstay of treatment for

ER+/HER2- mBC; however, ET resistance is common in the metastatic

setting. Aer progression on rst-line treatment, both ET monotherapy

and combination therapy options are available. Combinations such as

everolimus + exemestane and alpelisib + fulvestrant can be associated

with higher ecacy but also signicant toxicity, with discontinuation rates

~25%. For second-line treatment, combining fulvestrant with a CDK4/6i

is a recommended treatment option for CDK4/6i-naive pts (NCCN, 2022).

However, fulvestrant has low bioavailability and an IM injection burden.

e crosstalk between the three pathways ER, PI3K/AKT/mTOR and

cyclin-dependent kinases (CDK4/6) provide rationale for the combina-

tion of elacestrant, a next-generation oral SERD, with PI3K/AKT/mTOR

or CDK4/6 inhibitors to overcome endocrine resistance. e EMERALD

trial reported signicantly prolonged PFS with elacestrant vs SOC ET in

pts with ER+/HER2− ESR1 mutated mBC following disease progression

on prior ET (Bidard, 2022). Elacestrant was well tolerated with a manage-

able safety prole. Most adverse events, including nausea, were low-grade

and consistent with other endocrine therapies. Replacing the fulvestrant

backbone with elacestrant in combination with targeted agents enabling

oral-oral combinations is of therapeutic interest.

Methods: ELEVATE (NCT05563220) is a phase 1b/2 trial evaluating the

safety and ecacy of elacestrant combined with alpelisib, everolimus,

palbociclib, abemaciclib, and ribociclib. Eligible pts must be adults with

conrmed ER+/HER2− advanced or mBC and have > 1 measurable

lesion as per RECIST v1.1. e main objective for Phase 1b is to deter-

mine the RP2D of elacestrant combined with other targeted agents. e

RP2D of elacestrant and abemaciclib will be determined in the ELECTRA

study (NCT05386108). e Phase 2 portion will evaluate the ecacy of

elacestrant combined with other study drugs for PFS; secondary objec-

tives include PK, ORR, DoR, CBR, PFS, and OS. Recruitment is actively

ongoing.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

275

Exploring Double Heterozygosities in Hereditary Breast and

Ovarian Cancer: Advancing Beyond Single Cases through

Comprehensive Analysis

Natalie Herold1; Christoph Engel2; Dorothee Speiser3; Tim Ripperger4;

Andrea Gehrig5; Nadia Harbeck6; Norbert Arnold7; Nicola Dikow8;

Susanne Ledig9; Elena Leinert10; Matthias Rath11; Eric Hahnen1;

Jan Hauke1; Susanne Morlot4; Nina Ditsch12; Julia Ritter13; Britta Blümcke1;

Jörg Schröder5; Anke Waha1; Anna Hester6; Monika Maringa1;

Bernadette Jäger14; Kerstin Rhiem1; Barbara Wappenschmidt1;

Christine Solbach15; Bernhard H.F. Weber16; Tobias Blaum17;

Christopher Schroeder18; Alexander Volk19; Bahriye Aktas20;

Marion Kiechle21; Cornelia Meisel22; Tanja Fehm14; Bernd Auber4;

Rita Katharina Schmutzler1; Monika M. Golas23

1Center for Familial Breast and Ovarian Cancer, Center for Integrated Oncology,

Medical Faculty, University Hospital Cologne, Cologne, Deutschland

2Institute for Medical Informatics, Statistics and Epidemiology, Leipzig

University, Leipzig, Deutschland

3Hereditary Breast and Ovarian Cancer Center Charité, Department of

Gynecology with Breast Center, Charité University Medicine Berlin, Berlin,

Deutschland

4Department of Human Genetics, Hannover Medical School, Hannover,

Deutschland

5Institute of Human Genetics, Julius-Maximilians-Universität Würzburg,

Würzburg, Deutschland

6Department of Gynecology and Obstetrics, Breast Center, LMU University

Hospital, Munich, Deutschland

7Department of Gynecology and Obstetrics, Institute of Clinical Molecular

Biology, University Hospital of Schleswig-Holstein, Christian-Albrechts-

University Kiel, Kiel, Deutschland

8Institute of Human Genetics, Heidelberg University, Heidelberg, Deutschland

9Institute of Human Genetics, University of Muenster, Muenster, Deutschland

10Department of Gynecology and Obstetrics, University Hospital Ulm, Ulm,

Deutschland

11Department of Human Genetics, University Medicine Greifswald, Greifswald,

Deutschland

12Department of Obstetrics and Gynecology, University Hospital Augsburg,

Augsburg, Deutschland

13Hereditary Breast and Ovarian Cancer Center Charité, Department of

Gynecology with Breast Center, Charité University Medicine Berlin and Labor

Berlin – Charité Vivantes GmbH, Berlin, Deutschland

14Department of Gynecology and Obstetrics, University Hospital Düsseldorf,

Heinrich-Heine University Düsseldorf and Center for integrated Oncology (CIO)

ABCD, Duesseldorf, Deutschland

15Center for Hereditary Breast and Ovarian Cancer, University Hospital Frankfurt,

Frankfurt, Deutschland

16Institute of Human Genetics, University of Regensburg and Institute of Clinical

Human Genetics, University Hospital Regensburg, Regensburg, Deutschland

17Department of Gynecology and Obstetrics, University Medicine Göttingen,

Goettingen, Deutschland

18Institute of Medical Genetics and Applied Genomics, University of Tübingen,

Tübingen, Deutschland

19Institute of Human Genetics, University Medical Center Hamburg-Eppendorf,

Hamburg, Deutschland

20Department of Gynecology, University of Leipzig Medical Center, Leipzig,

Deutschland

21Department of Gynecology and Center for Hereditary Breast and Ovarian

Cancer, Klinikum rechts der Isar, Technical University Munich, Munich,

Deutschland

22Department of Gynecology and Obstetrics, Technical University Dresden,

Dresden, Deutschland

23Human Genetics, Faculty of Medicine, University of Augsburg, and University

Hospital Augsburg, Augsburg, Deutschland

Background: Risk-adapted surveillance programs and risk-reducing sur-

gery for individuals with hereditary breast and/or ovarian cancer (HBOC)

represent a central advancement in clinical management. While risk-

adapted measures for carriers of a single HBOC-associated (likely) path-

ogenic variant (pV) have been established, that for individuals harboring

pVs in multiple cancer predisposition genes remain unclear.

Methods: Phenotypic traits of double heterozygous (DH) counselees, includ-

ing breast cancer (BC) receptor status, onset, and severity, were compared to

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 33

those of single heterozygous (SH) carriers in the German Consortium for

HBOC (GC-HBOC) registry of more than 27,000 pV carriers.

Result: In total, we identied more than 400 multiple heterozygous coun-

selees. For pV carriers tested for thirteen HBOC core genes, the preva-

lence of multiple heterozygosity was about 3%. BC in double heterozygous

(DH) females displayed a prevalent receptor phenotype, inuenced by

the distinct variant gene combinations. Triple-negative BC was enriched

in most BRCA1-involved gene combinations, as in BRCA1 SH carriers.

However, among BRCA1/CHEK2 DH carriers, BC predominantly exhib-

ited a hormone receptor-positive status. e age at which BC developed in

DH females corresponded to the cancer onset of counselees with a single

pV in the more penetrant gene. Signicantly, BRCA1/BRCA2 DH females

had a higher severity score as compared to BRCA1 or BRCA2 SH carriers.

Discussion: Our results emphasize a more frequent presence of multi-

ple heterozygosity, particularly DH, surpassing previous understanding.

Moreover, we provide evidence to suggest that the presence of a second

pV can inuence the disease prole.

Conclusion: Overall, our data underscore the necessity of taking into

account multiple heterozygosities when making clinical decisions – both

for the index counselees and their family members. Recognizing the

potential impact of multiple pVs on the phenotype could thereby enhance

the provision of more rened and personalized guidance and support.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

280

Information material for counselees, patients and health

professionals: results and lessons learned

Anja Tüchler1; Kristin Leyerer2; Kerstin Rhiem1; Susanne Weg-Remers2;

Rita Katharina Schmutzler1

1Zentrum Familiärer Brust- und Eierstockkrebs Uniklinik Köln, Köln, Deutschland

2Krebsinformationsdienst, Deutsches Krebsforschungszentrum, Heidelberg,

Deutschland

Background: Continuous advances in genetic testing in the context of

familial breast and ovarian cancer pose major communication challenges

for patients and health professionals. In addition, limited self-reported

health literacy was observed in the majority of the German population. To

address these issues, the Center for Hereditary Breast and Ovarian Cancer

and the Cancer Information Service developed information brochures for

both patients and health professionals within the “Innovative Partnership

for Action Against Cancer”(iPAAC) initiative.

Methods: Interviews and surveys were conducted to address the tar-

get groups’ needs. Complementary brochures for patients/counselees

and health professionals were developed, considering the current evi-

dence-based knowledge on familial breast and ovarian cancer. e bro-

chures for counselees/patients were written in easy and plain language,

respectively. e nal brochures are evaluated by the target groups in

user-tests.

Result: Within the project, ve brochures for patients/counselees (easy

and plain language) and health professionals were developed. Results of

user-testing will be presented. e results have been previously presented.1

Discussion and Conlusion: e brochures developed are aimed to

be disseminated within the 23 centers of the German Consortium for

Hereditary Breast and Ovarian Cancer and its > 200 cooperating certi-

ed breast and gynaecological cancer centers in Germany. In addition,

the Cancer Information Service will distribute the material online via its

well-established information channels.

Indication of source:

1 A. Tüchler et al. Information material for counselees, patients and health

professionals: results and lessons learned [abstract]. In: Abstract Book of

the 3rd International Conference on Cancer Prevention; 2022 Oct 26–27;

Heidelberg. Heidelberg: DKFZ; 2022. Abstract nr 27.

Disclosure Statement: e authors declare no conict of interest.

295

T helper cell response in seroma uid after breast cancer

surgery – results of the SerMa pilot study

Nicole Pochert1,2; Melitta Köpke2; Mariella Schneider2; Mathis Wild2,3;

Monika Golas4; Aline Metz1; Ludwig Christian Hinske3; Matthias Reiger1;

Udo Jeschke2; Christian Dannecker2; Claudia Traidl-Homann1;

Michael Untch5; Thorsten Kühn6; Nina Ditsch2

1Umweltmedizin, medizinische Fakultät, Universität Augsburg, Augsburg,

Deutschland

2Universitätsklinikum Augsburg, Klinik für Frauenheilkunde und Geburtshilfe,

Augsburg, Deutschland

3Department of Data Management and Clinical Decision Support, medizinische

Fakultät, Universität Augsburg, Augsburg, Deutschland

4Lehrstuhl für Humangenetik, medizinische Fakultät, Universität Augsburg,

Augsburg, Deutschland

5Helios Klinikum Berlin-Buch, Klinik für Frauenheilkunde und Geburtshilfe,

Berlin, Deutschland

6Filderklinik, Klinik für Frauenheilkunde und Geburtshilfe, Esslingen,

Deutschland

Background: Seroma formation is one of the most frequent complications

aer breast cancer surgery, especially aer simple mastectomy. e aim of

the SerMa pilot study was to investigate immunological processes respon-

sible for seroma formation. Identication and characterization of immune

cell populations as well as specic immune reactions found in seroma

uids (SFl) and peripheral blood (PB) of patients aer breast cancer sur-

gery were therefore the main points of interest.

Methods: Flow cytometry analyses of SFl from breast cancer patients who

developed seroma aer surgery were performed to identify the immune

cell content. Immune cells were measured in comparison to PB of the

same patient and in contrast to healthy controls.

Result: Granulocytes and Monocytes were signicantly reduced in SFl

compared to PB of patients and healthy controls, while lymphocytes were

signicantly elevated. Within the lymphocyte compartment B cells, NK

cells and cytotoxic T cells were signicantly reduced in SFl. In contrast,

T-helper cells – primarily 2 and 17 were signicantly elevated in SFl

as well as in PB of patients compared to controls. 22 and Treg showed

signicant higher values in SFl compared to PB (patients and healthy con-

trols). In addition, cells with the activation marker HLA-DR on their sur-

face were measured in signicantly higher percentages in SFl and PB of

patients compared to controls, whereas naïve cells were reduced.

Discussion: Within our SerMa pilot study, we were able to identify a spe-

cic immune response in breast cancer patients with seroma formation.

We succeeded in identication of a general upregulation of T-helper cells

in SFl, whereas other immune cells have been decreased. 2 and 17 are

both known as marker for regulation of immune responses.

Conclusion: e signicant increase of 2/17 cells in patients could

be potential biomarkers for seroma formation. e detection of these

specic immune cell changes in SFl indicate an inammatory response,

also shown by the increased presence of HLA-DR+ cells and reduction

of naive cells.

Disclosure Statement: e authors declare no conict of interest.

326

Urinalysis of breast cancer patients identies disease-specic

miRNA patterns

Jochen Maurer; Elmar Stickeler

Uniklinik RWTH Aachen, Gynäkologie und Geburtsmedizin, Aachen,

Deutschland

Background: One in eight women will suer from breast cancer. Markers,

ideally non-invasive, for early detection, diagnosis and progression mon-

itoring are key in future therapy. Small RNA molecules, like miRNAs, are

very stable in almost all body uids and could serve as these sought-aer

markers.

Methods: Using an isolation of total miRNA from 4 milliliters of urine

samples (slightly less than a teaspoon), 82 women (50 healthy individuals

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts34

and 32 breast cancer patients) were studied using miRNA-sequencing to

determine whether consistent patterns of miRNA regulation could be

found despite this small amount.

Result: From a still small group of patients we generated the rst data

using miRNA chip analysis, but these are already very promising for the

possibility of valid testing of the disease by urinalysis. e primary goal

was to validate the patterns found in a larger group of patients. erefore,

we subsequently validated and evaluated the recently tested method of

miRNA sequencing in our clinic on the larger (82) sample cohort and

investigated to what extent the predictive power for breast cancer sub-

type patterns of miRNAs holds up or can even be improved in this larger

cohort. e sequencing analysis reliably detected over 4000 individual

miRNAs in each patient. Analysis revealed subcategory specic miRNA

patterns that allowed us to stratify patients according to urinalysis.

Discussion: Our data indicate that urinalysis could be a valuable tool

in the non-invasive detection and monitoring of breast cancer patients.

Clearly this rst patient cohort is still too small to make predictions for

the disease as a whole but the distinct patterns of breast cancer subclasses

with only very few overlapping miRNAs between them makes a prognos-

tic value for these analyses highly likely.

Conclusion: We identied miRNA patterns in small urine samples from

breast cancer patients by using miRNA sequencing with Random for-

est analysis allowing us to distinguish healthy individuals from cancer

patients.

Disclosure Statement: e authors declare no conict of interest.

346

Genetic Testing Rate in Real World – Data from a large

University Breast Center

Carina Meyer; Nanette Kalmbach; Nora Amirpour-Mehrhof; Sarah Kelch;

Jenny Katharina Wagner; Nicole Zilski; Jens-Uwe Blohmer; Dorothee

Speiser

Charité - Universitätsmedizin Berlin, Campus Mitte, Klinik für Gynäkologie mit

Brustzentrum, Berlin, Deutschland

Background: is study aimed at identifying the rate of genetic

germline analyses and detected pathogenic germline variants in breast

cancer patients fullling either the family history criteria of Deutsche

Krebsgesellscha (DKG) or indication of targeted therapy.

Methods: Anonymized real-world patient data from Charité -

Universitätsmedizin Berlin from 2018-2022 were used for retrospective

analysis. Apart from indication, timing, and outcome of germline genetic

analysis, patients’ age, family history (using DKG checklist score), disease

progression and tumor characteristics (staging, HR/HER2 status, metas-

tasis), were analyzed. Data collection and analysis is currently underway

and will be completed in October 2023. Chi-square tests and Mann-

Whitney U tests were used to compare patients in dierent groups and to

analyze the dependencies of variables.

Result: e cohort consisted of n = 1535 breast cancer patients who pre-

sented at Charité - Universitätsmedizin Berlin between 2018 and 2022.

Of these, 384 (25%) receive a germline analysis and 1151 (75%) were

not tested on germline variants. Of the patients who received a germline

analysis, 173 (45%) were carriers of a pathogenic germline variant in one

of the actionable core genes. Full results on the prevalence and role of

germline analysis will be presented at the conference in 2024.

Discussion: e outcomes suggest less than optimal testing rates for

patients. is study could help to improve clinical practice in the treat-

ment of breast cancer and thus optimize the process of care. Furthermore,

the results could lead to better risk assessment and counseling of aected

patients.

Conclusion: Knowledge about pathogenic germline variants is important

for risk adapted screening and prevention of breast cancer and can also

decide on the use of targeted therapies in breast cancer patients.

Disclosure Statement: e authors declare no conict of interest.

364

Genotype-phenotype-association of common pathogenic

variants in BRCA1

Anna Knödler1; Nanette Kalmbach1; Julia Ritter2; Susanne Herbst2; Jenny

Katharina Wagner1; Nicole Zilski1; Jens-Uwe Blohmer1; Dorothee Speiser1

1ZFBREK; Charité - Universitätsmedizin Berlin, Berlin, Deutschland

2Labor Berlin – Charité Vivantes GmbH, Berlin, Deutschland

Background: Patients who carry a pathogenic germline BRCA1 variant

have higher risks to get breast or ovarian cancer in comparison to non-

carriers. Earlier studies showed that there is a genotype-phenotype corre-

lation depending on type and location of the pathogenic variant in BRCA1,

so that there might be a dierent clinical approach. e goal of this study

was to try to reproduce these results on data from the Hereditary Breast

and Ovarian Cancer Center at Charité Berlin.

Methods: is is a retrospective observational study with data of the

Hereditary Breast and Ovarian Cancer Center at Charité Berlin from 2016

to 2023. 628 patients (n=628) carrying a pathogenic or likely pathogenic

variant (ENIGMA classication V/IV) in BRCA1 were included in the

analysis. Patients were divided into groups, depending on the specic var-

iant and compared for age of onset, histology of tumors, further pheno-

typical characteristics and follow up. e data is currently being analysed

and exact results are expected for January 2024.

Result: Out of the 628 patients 294 (47%) already had a diagnosis of breast

cancer, 169 (26%) already had a diagnosis of ovarian cancer and 182 (29%)

were healthy at the time of counselling. Most of the patients carried the

BRCA1 founder mutation c.5266dupC, followed by the BRCA1 variants

c.4035delA and c.2411_2412delAG. Whether these variants dier in their

phenotypical characteristics will be shown in the nal presentation at the

conference.

Discussion: Results from our analysis will be compared to former studies

and presented in the conference.

Conclusion: is data could have an impact on risk counselling, risk

adapted screening and prevention as well as clinical treatment options

and life perspectives of patients and counselees carrying a pathogenic

germline variant in BRCA1 variant.

Disclosure Statement: e authors declare no conict of interest.

402

The SURVIVE-HERoes trial – a secondary adjuvant treatment

intervention study with trastuzumab-deruxtecan in early

breast cancer patients with HER2 positive/HER2 low tumors

and a molecular relapse based on a ctDNA-liquid biopsy

approach

Franziska Mergel1; Sophia Huesmann1; Kerstin Pster1; Angelina Fink1;

Henning Schäer1; Forca Mehmeti1; Tanja Fehm2; Volkmar Müller3;

Klaus Pantel4; Thomas W. P. Friedl1; Lisa Wiesmüller1; Ramona Erber5;

Arndt Hartmann5; Matthias Beckmann6; Peter Andreas Fasching6;

Andreas Hartkopf7; Brigitte Rack1; Wolfgang Janni1

1Klinik für Frauenheilkunde und Geburtshilfe (Frauenklinik) -

Universitätsklinikum Ulm, Ulm, Deutschland

2Universitätsklinikum Düsseldorf Klinik für Frauenheilkunde und Geburtshilfe,

Düsseldorf, Deutschland

3Universitätsklinikum Hamburg-Eppendorf Klinik und Poliklinik für Gynäkologie,

Hamburg, Deutschland

4Universitätsklinikum Hamburg-Eppendorf Center for experimental medicine,

Hamburg, Deutschland

5Universitätsklinikum Erlangen Institut für Pathologie, Erlangen, Deutschland

6Universitätsklinikum Erlangen Frauenklinik, Erlangen, Deutschland

7Universitätsklinikum Tübingen Frauenklinik, Tübingen, Deutschland

Background: In the new era of highly eective antibody drug conjugates

(ADC), secondary adjuvant (adj.) treatment options for early breast can-

cer (EBC) patients at a high risk of relapse arise. e ADC trastuzum-

ab-deruxtecan (T-DXd) has shown promising ecacy in patients with

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 35

HER2-positive and HER2-low metastatic breast cancer and is currently

tested in the post-neoadjuvant setting in patients with non-pCR. To

successfully apply ADCs as a secondary adj. treatment, identication of

patients who would benet the most is required. e detection of minimal

residual disease (MRD) using liquid biopsy, e.g. ctDNA, may oer a prom-

ising approach for patient selection. e ecacy of such a secondary adj.

treatment in terms of delaying or preventing distant metastases has yet to

be evaluated in a randomized trial.

Methods: e SURVIVE-HERoes trial is a prospective, randomized, open

label comparative Phase III superiority trial in patients with intermediate

to high-risk HER2-positive or HER2-low EBC. Patients have completed

primary breast cancer therapy and participate in the large breast cancer

surveillance trial SURVIVE (NCT05658172) and experience a molecu-

lar relapse, determined by a positive ctDNA result and negative imaging.

Patients will be randomized (2:1 allocation) to treatment with T-DXd ver-

sus standard of care for 12 months, ctDNA levels will be tested repeatedly.

e primary objective is the comparison of ctDNA clearance rates aer

6 months. Secondary objectives include overall survival, invasive dis-

ease-free survival, distant disease-free survival, quality of life and safety

of T-DXd.

Result: n/a

Conclusion: is trial is a proof of principle study with the aim to estab-

lish the ecacy of secondary adj. treatment with T-DXd in patients with

HER2-positive/HER2-low EBC, who are at high risk of relapse, as evi-

denced by detection of ctDNA. If successful, it could lead to a treatment

shi towards early intervention with secondary adj. targeted therapies fol-

lowing liquid-biopsy based MRD detection.

Disclosure Statement: e authors declare no conict of interest.

453

Analysis of Guideline Quality Indicator 8 - Radiation Therapy

after Breast Conservation Therapy - in the Cancer Registry

Mecklenburg-Western Pomerania

Gabriele Robers; Kerstin Weitmann; Kirsi Manz; Wolfgang Homann

Krebsregister Mecklenburg-Vorpommern, Institut für Community Medicine,

Universitätsmedizin Greifswald, Greifswald, Deutschland

Background: In 2022, analyses on the fulllment of the quality indica-

tors (QI) of the S3 guideline of breast cancer2 were presented at the 4th

Statewide Quality Conference of the Cancer Registry Mecklenburg-

Western Pomerania. It was investigated whether treatment according

to QI 8 (radiotherapy (RT) aer breast-conserving therapy (BCT)) has

an inuence on the overall survival of female patients in Mecklenburg-

Western Pomerania (M-V).

Methods: Patients with non-metastatic invasive breast cancer diagnosed

or treated in M-V between 2017 and 2021 were included in the analysis.

RT aer BCT (QI 8) was evaluated annually, considering the calculation

rules agreed among all clinical cancer registries according to §65c SGBV1.

Kaplan-Meier curves and Cox proportional hazards model (HR) were

used to evaluate the impact.

Result: Over the years, fulllment of QI 8 improved (2017: 84.1%, 2021:

90.4%). e absolute 3-year survival rate (SR) of patients with RT aer

BCT was 0.97 (95% condence interval (CI): 0.97 - 0.98), showing a sur-

vival advantage over patients without RT aer BCT (SR 0.89, CI: 0.86

- 0.92). e age-adjusted Cox-model showed a signicant eect of fulll-

ment QI 8 (HR 3.25, CI: 2.24 - 4.71, p<0.01).

Discussion: e eect of RT aer BCT must be veried by including other

factors such as grading or general condition of the patients.

Conclusion: e degree of fulllment of QI 8 of the S3 guideline of breast

cancer has increased over time in female patients in M-V. Among patients

meeting QI 8, absolute 3-year survival was signicantly longer compared

by patients without radiotherapy. Monitoring of QI and their presentation

at quality conferences are useful to further improve the quality of onco-

logical care.

Indication of source:

1 https://conuence.basisdatensatz.de/pages/viewpage.action?pageId=2820621,

Accessed 25.08.2023.

2 German Cancer Society, German Cancer Aid, AWMF: Interdisciplinary

Evidenced-based Practice Guideline for the Early Detection, Diagnosis,

Treatment and Follow-up of Breast Cancer, Version 4.4, 2021, AWMF

Registration Number: 032/045OL.

Disclosure Statement: e authors declare no conict of interest.

483

Exploring Mobile Health Apps for Breast Cancer Prevention

and Education: An In-depth Analysis of Features, Quality,

and Functionality

Stefanie Altmannshofer1,2,3; Madeleine Flaucher4; Milena Beierlein1,2,3;

Bjoern Eskoer4; Matthias Beckmann1,2,3; Peter Andreas Fasching1,2,3;

Hanna Hübner1,2,3

1Department of Gynecology and Obstetrics, Erlangen University Hospital,

Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen,

Deutschland

2Comprehensive Cancer Center ER-EMN, University Hospital Erlangen, Friedrich-

Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Deutschland

3Bavarian Cancer Research Center (BZKF), Erlangen, Deutschland

4Machine Learning and Data Analytics Lab, Friedrich-Alexander-Universität

Erlangen-Nürnberg (FAU), Erlangen, Deutschland

Background: Digital tools, such as mobile Health (mHealth) applications

(apps), are meanwhile widely accepted as necessary and popular resources

for the distribution of information and education by providing a variety

of functionalities and benets, such as tailored health information or real-

time monitoring of health behaviors. e aim of this study was the analy-

sis of features, quality and functionality of apps designed for breast cancer

prevention.

Methods: We systematically searched the Google Play and Apple App

Stores for apps addressing breast cancer topics. Apps were categorized in

ve groups: 1) prevention and enlightenment, 2) therapy, 3) aercare, 4)

for professionals and 5) others. ose assorted to the category “preven-

tion” were downloaded and analysed using the Mobile Application Rating

Scale (MARS). App characteristics were examined and associated with

MARS scores.

Result: e Google Play and Apple App Store search identied 391 and

189 apps, respectively. 89 and 38 apps were categorized as “prevention”, 44

and 32 as “therapy”, 6 and 22 as “aercare”, 9 and 5 as “for professionals”

and 50 and 29 apps as “others”, respectively. Aer removing duplicates,

53 and 20 apps remained in the category “prevention”. 19 and 7 apps were

analysed using MARS. e mean MARS scores were 3.07 (Google Play

Store) and 3.50 (Apple App Store). All MARS categories were signicantly

associated with apps developed by Health Organizations.

Discussion: More than 60% of the apps originated from sources with

questionable legitimacy or trustworthiness. Our data indicates that apps

developed in collaboration with health care professionals are of higher

quality.

Conclusion: Our study underscores both the potential and challenges of

mHealth apps for breast cancer prevention. Future eorts should prior-

itize collaboration with health care professionals, ensuring app legitimacy,

and continuing to enhance app quality, with the goal to provide valuable

tools for breast cancer prevention and enlightenment.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts36

484

RESCUER – Data harmonization of multiple clinical

trials – challenges and chances

Sarah Lehle1,2,3; Mathias Ernst1,2,3; Fara Brasó-Maristany4,5; Aleix Prat4,5,6;

Olav Engebraten7,8,9; Thomas Hatschek10,11; Theodoros Foukakis10,11;

Jon Amund Kyte2,12; Matthias Rübner1,2,3; Sabrina Uhrig1,2,3;

Matthias Beckmann1,2,3; Peter Andreas Fasching1,2,3;

Vessela N. Kristensen13,14; Hanna Hübner1,2,3,15

1Bavarian Cancer Research Center (BZKF), Erlangen, Deutschland

2Department of Gynecology and Obstetrics, University Hospital Erlangen,

Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen,

Deutschland

3Comprehensive Cancer Center ER-EMN, University Hospital Erlangen, Friedrich-

Alexander-Universität Erlangen-Nürnberg, Erlangen, Deutschland

4Department of Medical Oncology, Hospital Clínic, Barcelona, Spanien

5Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i

Sunyer Biomedical Research Institute, Barcelona, Spanien

6SOLTI Breast Cancer Research Group, Barcelona, Spanien

7Department of Tumor Biology, Oslo University Hospital Oslo, Oslo, Norwegen

8Department of Oncology, Oslo University Hospital, Oslo, Norwegen

9Insitute for Clinical Medicine, University of Oslo, Oslo, Norwegen

10Breast Cancer Center, Karolinska University Hospital, Stockholm, Schweden

11Department of Oncology-Pathology, Karolinska Institutet, Stockholm,

Schweden

12Department of Cancer Immunology, Institute for Cancer Research, Oslo

University Hospital, Oslo, Norwegen

13Department of Medical Genetics, Oslo University Hospital, Oslo, Norwegen

14Institute of Clinical Medicine, University of Oslo, Oslo, Norwegen

15Institut für Frauengesundheit GmbH, Erlangen, Deutschland

Background: e EU Horizon 2020 project RESCUER aims to investigate

tumor-specic mechanisms of treatment resistance with focus on targeted

therapies. Within multiple European clinical trials, the project is gather-

ing and integrating multidimensional data but also generating multi-omic

data. is data will be used to feed computational networks and create

in silico models to discover molecular signatures of resistance and pre-

dict response to therapies. To overcome the diering presentation of data

across clinical trials and nd similarities, data organization, -cleaning and

-integration are needed.

Methods: Clinical data from eight European trials was transferred to

a central data management unit and stored in a single database on MS

SQL Server 2016. For data integration into one data base an Extract-

Transform-Load (ETL) process was established. Due to heterogeneity, the

ETL processes had to be tailored to each individual dataset. To harmo-

nize the clinical variables of each study were translated into a xed master

dictionary.

Result: To ensure data privacy, each data transfer was regulated by trans-

fer agreements, data was anonymized and ethics committee approvals

were obtained. Other challenges included data heterogeneity and missing

data. Variables were coded dierently between trials or had to be calcu-

lated from multiple variables. Technical compatibility was an issue, as data

were submitted in various le formats. Out of eight datasets, one was sub-

mitted as a text le, ve as Excel les and two as SQL datasets, which made

preprocessing and transformations necessary. Data combination resulted

in a sample size of 1843 patients with 1200 hormone receptor positive and

HER2 negative, three HER2 receptor positive, 566 triple negative patients.

Discussion: Combing data sets is challenged by big organizational eort,

missing guidelines on data presentation and the need for data manage-

ment knowhow.

Conclusion: Overcoming the data heterogeneity can improve statisti-

cal power by combining data sets, and is essential to discovering eects

eciently.

Disclosure Statement: e authors declare no conict of interest.

537

Clinical results of the SerMa pilot study: Elderly and Patients

with Large Breast Volume Have an Increased Risk of Seroma

Formation after Mastectomy

Melitta Köpke1; Mathis Wild1,2; Mariella Schneider1; Nicole Pochert1,3;

Jacqueline Sagasser1; Felicitas Schneider1; Thorsten Kühn4,5;

Michael Untch6; Christian Ludwig Hinske2; Matthias Reiger3;

Claudia Traidl-Homann3; Christian Dannecker1; Udo Jeschke1;

Nina Ditsch1

1University Hospital Augsburg, Departement for Gynecology and Obstetrics,

Augsburg, Deutschland

2Institute for digital medicine, University Augsburg, Augsburg, Deutschland

3Environmental Medicine, University Augsburg, Augsburg, Deutschland

4Filderklinik, Clinic for Gynecology and Obstetrics, Filderstadt-Bonlanden,

Deutschland

5University Hospital Ulm, Department of Gynecology and Obstetrics, Ulm,

Deutschland

6Helios clinic Berlin-Bruch, Obstetrics and Gynecology, Berlin, Deutschland

Background: e pathophysiology behind seroma formation as common

postoperative complication aer ablative procedures for breast cancer is

poorly understood. In the clinical evaluation of the SerMa (Seroma for-

mations of the Mammary gland) pilot study, which investigates primarily

possible immunological or inammatory causes of seroma formation,

clinicopathological correlations between seroma formation and tumor

biology or lymph node involvement were analyzed and are presented here.

Methods: e collective of the SerMa pilot study included 100 cases of

primary breast cancer or carcinoma in situ who had undergone a mas-

tectomy procedure with or without implant-based reconstruction at

Augsburg University Hospital between 12/2019 and 12/2022.

Result: Seroma occurred signicantly more oen in older patients (median

age in cases with seroma 73 years vs. 52 years without seroma; p < 0.001).

In addition, patients with larger mastectomy specimen were signicantly

more likely to develop seroma (median weight in cases with seroma 580 g

vs. 330 g without seroma; p < 0.001). Other signicant parameters for

seroma formation were BMI (p = 0.005), grading (p = 0.015) and tumor

size (p = 0.036). Interestingly, with insertion of implant or expander, ser-

oma occurred signicantly less frequently (p < 0.001). In contrast, tumor

biological characteristics, number of lymph nodes removed or aected

showed no signicant eect on seroma formation.

Discussion: In the present study, there was no signicant inuence of

axillary tumor burden or tumor biologic characteristics on seroma forma-

tion. Since older patients in particular were at risk for seroma formation,

the present study shows the need for patient education in older patients

and patients with large breast volumes within the preoperative surgical

clarication.

Conclusion: ese clinicopathological data support the previously pub-

lished results hypothesizing that seroma formation is related to immuno-

logical processes and will be tested on a larger collective in the planned

international multicenter SerMa study (EUBREAST 5).

Disclosure Statement: e authors declare no conict of interest.

577

Diagnostic yield and clinical relevance of expanded germline

genetic testing for HBOC patients

Jan Henkel1; Andreas Laner1,2; Melanie Locher1,2; Tobias Wohlfrom1;

Birgit Neitzel1; Kerstin Becker1,2; Teresa Neuhann1,2; Angela Abicht1,2,3;

Verena Steinke-Lange1,2; Elke Holinski-Feder1,2,4; Nasge Konsortium2

1MGZ – Medizinisch Genetisches Zentrum, München, Deutschland

2NASGE, Nationale Allianz für seltene genetische Erkrankungen, Hannover,

Deutschland

3Friedrich-Baur-Institute, Department of Neurology, Klinikum der Universität,

Ludwig-Maximilians-Universität, München, Deutschland

4Department of Medicine IV, Klinikum der Universität, Ludwig-Maximilians-

Universität, München, Deutschland

Background: Although there are recommendations at national and interna-

tional level as to which genes should be analyzed in the context of a hereditary

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 37

breast and ovarian cancer (HBOC), the individual composition of the corre-

sponding gene panels varies, resulting in a dierent diagnostic yield.

Methods: We performed a retrospective analyzed NGS Datasets of sus-

pected HBOC patients who had been tested at various German diagnostic

laboratories that are part of the NASGE network and compared the most

common panel recommendations and an internal HBOC core gene panel

with each other. Additionally, we analyzed the data concerning other

potential tumor risk syndromes (TRS) not caused by pathogenic variants

in the core panel genes.

Result: We collected 29,317 HBOC datasets from various German

diagnostic laboratories. At least one pathogenic variant (class 4/5) was

reported in about 4000 datasets, resulting in a diagnostic yield of 14.5%.

We compared our internal HBOC core gene panel to one national and

dierent internationally recommended gene panels. e resulting diag-

nostic yield of pathogenic variants (class 4/5) varied from 9.0% to 13.8%

depending on the panel evaluated, with the internal panel having a yield

of 12.7%. In about 1%, a pathogenic variant outside the established HBOC

core genes was identied, leading to a TRS diagnosis.

Discussion: ese results are consistent with previous observations that

a signicant proportion of patients with hereditary cancer predisposition

were not detected by the guideline-based gene panels and suggest that

expanded diagnostics compared to currently recommended multigene

panels may identify additional patients at high risk for developing cancer.

Conclusion: We suggest to follow-up a medium sized core panel by a com-

prehensive cancer panel to identify additional TRS in patients referred

to HBOC testing, which would not have been detected by current rigid

guideline-based testing.

Disclosure Statement: e authors declare no conict of interest.

624

Empowering Cancer Care: Feasibility and Acceptance of

a Digital Home-Based Health Care Monitoring System for

CDK4/6 Inhibitor Therapy

Hanna Hübner1,2,3; Lena Wurmthaler1,2,3; Chloë Goossens1,2,3;

Mathias Ernst1,2,3; Katharina Seitz1,2,3; Matthias Rübner1,2,3;

Matthias Beckmann1,2,3; Peter Andreas Fasching1,2,3

1Bavarian Cancer Research Center (BZKF), Erlangen, Deutschland

2Department of Gynecology and Obstetrics, University Hospital Erlangen,

Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen,

Deutschland

3Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen,

Friedrich-Alexander-Universität Erlangen-Nürnbergy, Erlangen, Deutschland

Background: Systemic cancer therapies oen lead to side eects that

require regular monitoring. e integration of real-time remote monitor-

ing by using e-health technologies has the potential to enhance cancer

care and to empower patients. e purpose of the SMILER study was to

assess the feasibility and acceptance of a digital home-based health care

system (DHHC).

Methods: e SMILER study (“Smart and Interactive Home Based Health

Care Project – A Digital Healthcare Feasibility Pilot Study Including the

d.H2C2 Initiative”) enrolled patients diagnosed with HR+, HER2-breast

cancer receiving cyclin-dependent kinase (CDK) 4/6 inhibitor treat-

ment. Study participants were provided with a DHHC setup. Data from

home-based measurements, including white blood cell (WBC) counts,

electrocardiograms (ECGs), quality of life questionnaires, and photo doc-

umentation, were collected at scheduled time points. Technical issues,

adherence rates, user perceptions, and acceptance were evaluated through

questionnaires and data analysis.

Result: 76 patients participated in the study, with a mean age of 59 years. e

average adherence to scheduled remote visits were of 43% and 26% on day

14 and day 28, respectively. Participants generally found the DHHC easy to

use, integration into daily life was well-perceived, and willingness to continue

using such a system was expressed. Correlations between home-based and

routine measurements for WBC counts and ECG values were signicant.

Discussion: is study demonstrated a high acceptance of the DHHC for

cancer care. Technical challenges and adherence issues were encountered,

emphasizing the need for ongoing renement and support to ensure eec-

tive implementation.

Conclusion: e positive feedback and acceptance from participants in

this study highlighted the relevance and potential of such digital solutions.

Further research is warranted to evaluate the impact of these interven-

tions on patient outcomes and healthcare resource utilization.

Disclosure Statement: e authors declare no conict of interest.

661

Exploring Personalized Medicine in Breast and Gynecologic

Cancer: Unveiling the Molecular Landscape and Patient

Outcomes from the Molecular Tumor Board Freiburg (MTB-FR)

Using Real-World Data

Linda Gräßel1,2; Johannes Jung1,3,4; Patrick Metzger5; Dorothee Jakob6;

Marlene Mathis6; Thomas Pauli5; Michael Kruszewski2; Mehtap Yücel2;

Michaela Bossart6,7; Thalia Erbes6; Silke Lassmann8,9; Cornelius Miething2,9;

Heiko Becker2,9; Ingolf Juhasz-Böss6; Martin Werner8,9; Justus Duyster1,2,9;

Mtb-Fr Network9; Florin-Andrei Taran6; Melanie Börries1,5,9; Lena Illert1,2,3,4,9

1German Cancer Consortium (DKTK) and German Cancer Research Center

(DKFZ), Heidelberg, Deutschland

2Department of Hematology, Oncology, and Stem Cell Transplantation, Faculty

of Medicine, Freiburg University Medical Center, Freiburg, Deutschland

3Center for Personalized Medicine, Klinikum r.d. Isar, Technical University

Munich, München, Deutschland

4Clinic and Polyclinic for Hematology and Oncology, Faculty of Medicine,

Technical University of Munich, München, Deutschland

5Institute of Medical Bioinformatics and Systems Medicine, Freiburg University

Medical Center, Faculty of Medicine, University of Freiburg, Freiburg,

Deutschland

6Department of Obstetrics and Gynecology, Faculty of Medicine, Freiburg

University Medical Center, Freiburg, Deutschland

7Clinic for Obstetrics and Gynecology, St. Josefskrankenhaus, Freiburg,

Deutschland

8Department of Pathology, Faculty of Medicine, Freiburg University Medical

Center, Freiburg, Deutschland

9Comprehensive Cancer Center Freiburg, Faculty of Medicine, Freiburg

University Medical Center, Freiburg, Deutschland

Purpose: e primary goal of the Molecular Tumor Board Freiburg

(MTB-FR) is to identify and evaluate potential molecular targets for

personalized therapeutic approaches in advanced cancer patients who

are particularly young, show surprising disease progression or response

under therapy and/or are faced with limited conventional treatment

options. Breast cancer is the most common cancer worldwide and, based

on current incidence rates, statistically one in eight women in Germany

will develop breast cancer in her lifetime.

Advances in research and early detection, along with improved targeted

therapies, have signicantly improved the prognosis for these patients.

However, breast cancer remains a leading cause of cancer-related death in

women and a signicant contributor to female morbidity and mortality.

e aim of this study is to report the patient characteristics, molecular

landscape, and clinical outcomes of the breast and gynecologic cancer

patients discussed at the MTB-FR between 2015 and 2022.

Methods: All patients diagnosed with breast or gynecologic cancer

between 2015 and 2022 and enrolled in the MTB-FR registry study were

included in this ongoing comprehensive analysis of molecular genetic,

histopathologic, demographic, and outcome data.

Results: Data analysis is currently in progress and nal results will be pre-

sented at the conference.

Discussion: Beyond its immediate impact on patient care, the Molecular

Tumor Boards hold a signicant role in scientically evaluating the

molecular landscape and the therapeutic responses of patients undergoing

targeted treatments. is contributes to a reverse-translation process that

informs the development of future therapies and facilitates the initiation

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts38

of molecularly tailored clinical trials. e primary objective is to provide

an in-depth characterization of the molecular landscape and clinical out-

comes of the breast cancer and gynecological tumor patients discussed at

the MTB-FR from 2015 to 2022, with the intent of sharing these insights

at the conference.

Disclosure Statement: e authors declare no conict of interest.

719

Toxicity and health-related quality of life (HRQOL) outcomes

after intraoperative radiotherapy (IORT) as a boost

compared to simultaneous integrated boosts (SIB) after

breast-conserving therapy for breast carcinoma

Raluca G. Stoian1,2; Jan-Philipp Exner1; Mark Gainey1; Thalia Erbes3;

Eleni Gkika1; Ilinca Popp1; Simon Kb Spohn1; Ingolf Juhasz-Böss3;

Anca-L. Grosu1,2; Tanja Sprave1,2

1Universitätsklinikum Freiburg -Klinik für Strahlenheilkunde, Freiburg im

Breisgau, Deutschland

2German Cancer Consortium (DKTK), partner site DKTK-Freiburg, Deutschland,

Freiburg im Breisgau, Deutschland

3Universitätsklinikum Freiburg Klinik für Frauenheilkunde, Freiburg im Breisgau,

Deutschland

Background: Adjuvant whole breast irradiation (WBI) aer breast-

conserving surgery (BCS) signicantly reduces the risk of local recurrence

and increases overall survival. Tumor bed boost additionally reduces the

risk of local recurrence. e aim of this retrospective analysis was to com-

pare acute and chronic toxicity and health-related quality of life (HRQOL)

aer intraoperative boost application (IORT) and simultaneous integrated

boost (SIB) for WBRT aer BEO.

Methods: 120 patients with breast carcinoma were treated by IORT or WBI

with SIB at the University Freiburg: IORT 1x20 Gy and WBI 50 Gy in 25 or

40.05 in 15 fractions vs. WBI 50 Gy plus SIB 60 Gy in 25 fractions. Toxicity

was compared in a collective created using propensity-score-matching

analysis. HRQOL was assessed using the validated EQ5D-5L questionnaire

before the start and end of therapy and at the rst follow-up. Dierences in

HRQOL within and between groups were analyzed by Kurskall-Wallis test

and Mann-Whitney U test.

Result: 1:1 propensity-score matching resulted in an IORT and SIB

cohort of 60 patients each. e most common acute adverse event

in both groups was radiodermatitis without a signicant dierence

(p=0.309). Signicantly higher fatigue grade 1 was shown in IORT cohort

with 13 (21.7%) vs SIB cohort with 4(6.7%) (p=0.041). Intramammary

lymphedema grade 1 occurred signicantly more oen in the IORT group

with 7(11.7%) vs 1(1.7%) in the SIB group (p=0.026). Both groups showed

comparable late toxicity. In the IORT, HRQOL at therapy start, end and

rst follow-up were respectively: 0.908, 0.852 and 0.928 vs. the SIB group:

0.922, 0.857 and 0.876. HRQOL change within the IORT group and SIB

group was signicant with p=0.005 each. No signicant dierences in

HRQOL were detected between both groups at all time points.

Conclusion: Dose boost in the tumor bed using IORT and SIB techniques

aer BCS achieves comparable good local control and late toxicity. Both

techniques also show a similar trajectory of HRQOL although IORT

application shows a moderate increase in acute toxicity.

Reference:

1 Senologie Kongress 2023.

Disclosure Statement: e authors declare no conict of interest.

744

PI3KCA somatic mutations in pramry male breast cancer

Sabine Lubig1; Lara Hoppenrath1; Melanie Erices-Leclercq1;

StephanBaldus2; Robert Förster3; Frank Förster4; Christian Rudlowski1;

Thomas Barthel5

1Frauenklinik, Evangelisches Krankenhaus Bergisch Gladbach, Bergisch

Gladbach, Deutschland

2Institut für Pathologie und Zytopathologie, Bergisch Gladbach, Deutschland

3Institute for Radiation Oncology, Cantonal Hospital Winterthur, Winterthur,

Schweiz

4Department of Economical Sciences, University of Applied Sciences, Zwickau,

and Outpatient Department of Gynecological Oncology and Palliative Care,

Poliklinik GmbH, Chemnitz, Deutschland

5Novartis Pharma GmbH, Nürnberg, Deutschland

Background: Breast cancer patients with PI3KCA somatic mutations ben-

et from treatment with PI3K inhibitors. Studies are lacking to identify

PI3KCA mutations in male breast cancer (MBC) patients. e evidence

of PIK3CA mutations in MBC could oer new treatment options for this

distinctive subgroup. In this study we evaluate frequency and spectrum of

PIK3CA mutations in primary male MBC.

Methods: Paran-embedded tumor samples from 131 male patients

who were diagnosed and treated for primary invasive breast cancer from

1995 to 2022 at Breast Cancer Units in Bergisch Gladbach, Chemnitz

and Zwickau, Germany were collected. Proportion and distribution of

PI3KCA mutations were assessed by next-generation sequencing (NGS).

Results were statistically correlated with patient characteristics and

follow-up data.

Result: At present 87 out of 131 cases were evaluated. 23 tumors (26.4%)

showed PIK3CA mutations. 11 patients had a H1047R mutation, 5 patients

a E656K, two patients a H1057L mutation and one patient each showed

a E103_P104del, C420R, E453K, E542K and H855Y mutation. Frequency

and spectrum of PIK3CA mutations did not correlate with tumor charac-

teristics and patients survival.

Discussion: is is the rst comprehensive study that evaluates PIK3CA

mutations by NGS in primary MBC. e results demonstrate that more than

25% of the MBC patients could benet from a PIK3CA targeted therapy.

Studies with larger cohorts of MBC patients are needed to determine the

prognostic value of frequency and spectrum of PIK3CA mutations in MBC.

Conclusion: A signicant part of primary MBC shows PIK3CA muta-

tions and are suitable for PIK3CA targeted therapy.

Disclosure Statement: e authors declare the following: e authors declare that

they received research funding from Novartis AG to evaluate PIK3CA mutations

in this study.

760

Development of a decision support system to reduce the time

burden of interdisciplinary tumor conferences, using the

example of a Certied Breast Cancer

Thomas Elter1,2,3; Paulina Klose4; Laura Hamacher1; David Hoier2,5;

MichaelHallek1; Carolin Groß-Opho-Müller2,6; Andreas Greeske2;

JonasHeidelbach2; Cristin Kuehn7; Wolfram Malter4

1University of Cologne, Department I of Internal Medicine, Center for Integrated

Oncology Aachen Bonn Cologne Duesseldorf, Cologne, Deutschland

2Onqo Health GmbH, Cologne, Deutschland

3University of Cologne, Department I of Internal Medicine, Center for Integrated

Oncology Aachen Bonn Cologne Duesseldorf, Cologne, Deutschland

4University of Cologne, Breast Cancer Center, Center for Integrated Oncology

Aachen Bonn Cologne Duesseldorf, Cologne, Deutschland

5St. Martinus Krankenhaus, Duesseldorf, Deutschland

6Kliniken der Stadt Köln gGmbH, Köln, Deutschland

7Brustzentrum Unna-Lünen, Lünen

Background: We developed a decision support system (DSS) for breast

cancer multidisciplinary tumor boards (MTB) that provides treatment

recommendations for predened standard cases when the cases are regis-

tered for presentation at MTB.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 39

Methods: We created a query algorithm that simulated a MTB registra-

tion and requested all necessary information to provide treatment rec-

ommendations. is algorithm was then implemented in the oncology

smartphone application “EasyOncology” to easily match and analyze DSS

and MTB decisions. e evaluation included 348 stage I-IIB (M0) and

1036 stage IV (M1) breast cancer cases discussed at the M0 and M1 MTB’s

of the University Hospital Cologne from 2018 to 2022.

Result: Of those cases with complete board documentation, 222 cases

fullled pre-selection criteria for assumed “standard cases”, most of them

localized breast cancer cases (n=151) and only 71 M1-cases. First analysis

showed a concordance rate for DSS and MTB decisions of 91.4% (n=138)

in the M0 cohort and 71% (n=17) in the M1 cohort. ose factors that

were not suitable for preselection of standard cases were identied and the

query was adapted accordingly (e.g. luminal B subtype in M0 or hormone

receptor switch in relapsed M1). e results of the second analysis with

adjusted query will be presented.

Discussion: It must be underlined that the goal of our work is not to

replace medical expertise. Instead, our premise is to ease MTB’s time

burden by providing recommendations for “simple” cases which are

identied by reliable criteria. ese standard cases would be documented

accordingly in the MTB protocol and could only be discussed optionally.

Conclusion: Besides reduction of documentation burden and quality

assurance, our automated approach would allow more time for the discus-

sion of the complex tumor cases.

Disclosure Statement: e authors declare the following: omas Elter is founder

and CEO of Onqo Health GmbH Carolin Groß-Opho-Müller is a research

assistant at Onqo Health GmbH David Hoier is a research associate at Onqo

Health GmbH, Jonas Heidelbach is CMO and Andreas Greeske the CTO

of Onqo Health.

762

Phase 3 study of tucatinib or placebo in combination with

trastuzumab and pertuzumab as maintenance therapy for

HER2+ metastatic breast cancer (HER2CLIMB-05, trial in

progress)

Verena Kiver1; Erika Hamilton2; Junji Tsurutani3; Giuseppe Curigliano4;

Miguel Martín5; Ciara O’sullivan6; Joo Hyuk Sohn7; Konstantinos

Tryfonidis8; Libero Santarpia9; Shan Yang9; Véronique Diéras10

1Charité – Universitätsmedizin Berlin, Berlin, Deutschland

2Sarah Cannon Research Institute, Nashville, TN, USA

3Advanced Cancer Translational Research Institute at Showa University,

Tokyo,Japan

4European Institute of Oncology, IRCCS, University of Milano, Milan, Italien

5Hospital General Universitario Gregorio Marañón, Madrid, Spanien

6Mayo Clinic, Rochester, MN, USA

7Yonsei Cancer Center, Seoul, Republik Korea

8Merck & Co Inc, Rahway, NJ, USA

9Seagen Inc., Bothell, WA, USA

10Eugene Marquis Center, Rennes, Frankreich

Background: e current rst-line (1L) standard of care (SOC) for human

epidermal growth factor receptor 2-positive (HER2+) metastatic breast cancer

(MBC) is trastuzumab (T) plus pertuzumab (P) and a taxane; most patients

(pts) progress during maintenance therapy with T+P. Tucatinib is a tyrosine

kinase inhibitor (TKI) approved in combination with T and capecitabine for

HER2+ MBC with and without brain metastases (BM). In HER2CLIMB, the

addition of tucatinib signicantly improved outcomes in pts with HER2+

MBC, was well tolerated, and reduced the risk of disease progression or

death in pts with untreated and/or active BM. HER2CLIMB-05 investigates

whether adding tucatinib to 1L SOC as maintenance therapy will extend pro-

gression-free survival (PFS) while maintaining quality of life (QOL).

Methods: HER2CLIMB-05 (NCT05132582) is a phase 3, randomized,

double-blind study evaluating tucatinib plus T+P as maintenance ther-

apy for HER2+ MBC. Approximately 650 pts will be enrolled. Eligible

pts will have advanced HER2+ disease, no progression on 4-8 cycles of

prior 1L SOC, Eastern Cooperative Oncology Group Performance Status

of 0 or 1, and no or asymptomatic BM. Exclusion criteria include prior

treatment with anti-HER2 and/or anti-epidermal growth factor receptor

TKI (priorSOC for early BC is permitted) or inability to undergo contrast

magnetic resonance imaging of the brain.

Pts will be randomized 1:1 to receive either tucatinib or placebo twice

daily, with T+P once every 21 days. Pts with hormone receptor-positive

disease may receive endocrine therapy. e primary endpoint is inves-

tigator-assessed PFS. Secondary endpoints include overall survival (OS),

time to deterioration of health-related QOL, central nervous system PFS,

safety, and pharmacokinetic parameters.

Enrollment is ongoing in Germany, Belgium, Switzerland, Austria, France,

Spain, Portugal, Italy, Greece, the UK and the US, and several Asia-Pacic

and Latin America countries.

is abstract was previously presented at ESMO-BC 2022, Final Publication

Number: 415, by Véronique Diéras (reused with permission).

Disclosure Statement: e authors declare no conict of interest.

810

A prospective, randomized superiority trial for liquid-biopsy

based early breast cancer follow-up – the SURVIVE-Study

Sophia Huesmann1; Franziska Mergel1; Kerstin Pster1; Angelina Fink1;

Forca Mehmeti1; Henning Schäer1; Tanja Fehm2; Volkmar Müller3;

KlausPantel4; Thomas W. P. Friedl1; Lisa Wiesmüller1; Andreas Hartkopf5;

Ramona Erber6; Arndt Hartmann6; Matthias Beckmann7; Peter Andreas

Fasching7; Brigitte Rack1; Wolfgang Janni1

1Klinik für Frauenheilkunde und Geburtshilfe (Frauenklinik) -

Universitätsklinikum Ulm, Ulm, Deutschland

2Universitätsklinikum Düsseldorf Klinik für Frauenheilkunde und Geburtshilfe

Notaufnahme, Düsseldorf, Deutschland

3Universitätsklinikum Hamburg-Eppendorf Klinik und Poliklinik für Gynäkologie,

Hamburg, Deutschland

4Universitätsklinikum Hamburg-Eppendorf Center for experimental medicine,

Hamburg, Deutschland

5Universitätsfrauenklinik Tübingen, Tübingen, Deutschland

6Universitätsklinikum Erlangen Pathologisches Institut, Erlangen, Deutschland

7Universitätsklinikum Erlangen Frauenklinik, Erlangen, Deutschland

Background: Due to data published in the 1990s lacking the evidence of

superiority in screening for distant metastases, imaging in early breast

cancer (EBC) follow-up is limited to detecting local recurrence. Modern

studies investigating EBC follow-up and an impact of earlier detection of

distant metastases are missing entirely.

Methods: e SURVIVE study is a prospective, 1:1 randomized, con-

trolled, partly-blinded trial, including 3500 medium to high-risk EBC

patients aer completion of primary antitumor therapy. Participants

are randomized to either Standard or liquid-biopsy based Intensive

Surveillance. Blood sampling at 150 study centers in Germany will occur

in guideline-based intervals for EBC follow-up (three monthly year 1-3,

6 monthly years 4-5 aer completion of primary therapy). While the

Standard Surveillance samples will be stored in a biobank for translational

studies, the samples of the Intensive Surveillance arm will be analyzed for

tumor markers (CA27.29, CEA, CA125), circulating tumor cells (CTC)

and circulating tumor-DNA (ctDNA). Indicative of minimal residual

disease, imaging will be triggered if any of these markers show a pre-

specied abnormal result. If secondary disease is detected, patients will

receive standard of care for metastatic disease. If imaging shows no signs

for metastases, patients will continue liquid-biopsy testing and may get

the chance to participate in therapy-intervention studies at the stage of

molecular relapse. e Co-primary endpoints of this study are overall sur-

vival and the detected lead-time in the Intensive Surveillance arm (earlier

detection of metastasis compared to Standard Surveillance).

Result: n/a.

Conclusion: e SURVIVE-study aims to question 30-year-old data and

its relevance in times of modern diagnostics and therapeutic regimes.

is study not only opens up the possibility for patients to participate in

therapy-intervention studies at the stage of molecular-relapse, but may, if

positive, lead to a paradigm shi in EBC follow-up.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts40

837

Impact of TMEM16F (ANO6) activity on fusion of human

mammary epithelial cells and human breast cancer cells

Leonie Huwa; Maja Kneissig; Thomas Dittmar

Chair of Immunology, Center for Biomedical Education and Research (ZBAF),

University of Witten/Herdecke, Witten, Deutschland

Background: Cell fusion is mandatory for physiological processes,

such as placentation and myogenesis, and pathophysiological processes,

including cancer. It has been demonstrated that the phospholipid phos-

phatidylserine (PS) plays a crucial role in cell merger. Translocation of PS

from the inner to the outer leaet of the plasma membrane is facilitated

by scramblases, such as TMEM16F (ANO6). Inhibition of scramblase

activity was correlated with reduced PS externalization and diminished

syncytia formation. Here, the impact of TMEM16F (ANO6) activity on

the fusion of human mammary epithelial cells and human breast cancer

cells was investigated.

Methods: TMEM16E,-F,-G expression in human mammary epithe-

lial cells (M13SV1-Syn1-DSP8-11) and human breast cancer cells

(HS-578-T-DSP1-7; MDA-MB-231-DSP1-7) was determined by qPCR.

TMEM16F (ANO6) activity was blocked using dierent concentrations of

Niclosamid, Hexachlorophen, Salinomycin and Clofazimin and CRISPR/

Cas9 knockout. Fusion-frequency (DSP1-7 + DSP8-11 = GFP) of the cells

was determined by FACS. Additionally, the impact of the inhibitors on cell

proliferation and colony formation was analyzed.

Results: TMEM16F (ANO6) expression is only expressed in breast cancer

cells. Used drugs led to increased fusion rates and most of them reduced

the colony formation potential without having an impact on cell prolifera-

tion. Successful TMEM16F (ANO6) CRISPR/Cas9 knockout in HS578T-

DSP1-7-cells was validated by sequencing.

Discussion: Used drugs seem to activate cell fusion, which is in contrast

to the hypothesis that TMEM16F (ANO6) inhibition impairs cell merger.

No toxic eects of the used drugs were observed. How exactly the used

drugs trigger cell fusion remains unknown.

Conclusion: In summary, the study shows that TMEM16F (ANO6) is

likely not involved in the fusion of breast cancer cells and human mam-

mary epithelial cells. Nonetheless, further studies are recommended to

investigate the impact of scramblase activity and PS on cancer cell fusion.

Disclosure Statement: e authors declare no conict of interest.

841

Impact of microplastic on mammary epithelial cells,

breast-cancer-cells and cell fusion

Maximilian Schnee1; Thomas Dittmar2

1Chair of Immunology, Center for Biomedical Education and Research (ZBAF),

University of Witten/Herdecke, Witten, Deutschland

2Chair of Immunology, Center for Biomedical Education and Research (ZBAF),

University of Witten/Herdecke, Witten, Deutschland

Background: Plastic pollution of the environment is becoming a tre-

mendous problem of recent times. Only a few eects on human health

have been researched so far. e aim of the study was to investigate the

inuence of microplastics (MPs) on human mammary epithelial cells and

human breast cancer cells.

Methods: Human mammary epithelial cells (M13SV1-Syn1-DSP8-11)

and breast cancer cells (HS-578-T-DSP1-7 and MDA-MB-231-DSP1-7)

were co-cultivated with green uorescent polystyrene (PS) microbeads for

up to 72h. e PS-microbeads were used in three dierent granulometries

(0.5µm, 1.0µm, 4.5µm). Particle absorption and the cell fusion rate were

measured by FACS (DSP1-7 + DSP8-11 = GFP). Cell proliferation and

Scratch/wound healing assay was quantied using the Incucyte® SX5 sys-

tem. Colony formation capacity was analyzed by crystal violet staining.

Results: Regarding all three cell lines a dose and particle size dependent

uptake was detected. e dierent particle granulometries had no signif-

icant eects on the fusion rates and the colony formation capacities of

the cells. In contrast, cell proliferation studies demonstrated that in the

MDA-MB-231 cells, the 1.0µm and in the M13SV1-Syn1 cells the 0.5µm

PS-particles resulted in increased proliferation rates. However, cell migra-

tion was accelerated by MPs.

Discussion: One suspected reason why in this study some investigated

cell mechanisms remained unaected could be the relatively short expo-

sure of the cells to the MPs. Aer all, cancer does not manifest itself over

a few days, and so it is not surprising that exposure to microplastics can

have eects on cells and potential malignancy only aer a longer period

of time.

Conclusion: In summary, MPs were uptaken in a dose and particle size

dependent manner by human breast cancer cells and mammary epithe-

lial cells and have an impact on cell proliferation and migration. Whether

microplastic in general might be a risk factor for breast cancer progression

needs to be evaluated in further studies.

Disclosure Statement: e authors declare no conict of interest.

845

Inuence of NEDD9 in TNBC breast cancer stem cells

Thomas Hansen; Saskia Breuel; Elmar Stickeler; Jochen Maurer

Uniklinik Aachen, Aachen, Deutschland

Background: During breast cancer treatment, therapy resistance and

metastatic dissemination are the main problems that have to be faced.

Breast cancer stem cells (BCSC) have been suggested to be responsible

for both therapy resistance and metastatic dissemination. e scaolding

protein NEDD9 regulated by cell attachment, growth factors and chemok-

ine signaling is linked to migration, proliferation and survival pathways.

High expression of NEDD9 promote metastasis and drug resistance and

correlate with a poor prognosis in several cancers including TNBC.

Methods: BCSCs were transduced via virus to either overexpress NEDD9

or knockout NEDD9 depending on the protein expression of NEDD9 in

wild type cells. Aerwards functional assays (proliferation, scratch/inva-

sion, CFU) and quantitative assays were performed to analyze the eects.

Finally selected cell lines were transplanted in mice.

Result: We found that NEDD9 overexpression leads to an increased

migration in BCSCs. Furthermore the CFU showed that despite the

amount of spheres was equal the size of NEDD9 overexpressing spheres

was signicantly smaller. e same was found for tumor size in an animal

experiment.

Discussion: We show that NEDD9 overexpression can reduce tumor

growth although most literature deviate from this. One hint is a shi in

the stem cell population. e exact mechanism needs to be claried.

Conclusion: Taken together NEDD9 showed a promising potential in

BCSCs which needs to be further examined.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 41

931

Feasibility of targeted therapies in the adjuvant setting

of early breast cancer in men -real-world data from a

population-based registry

Marie Louise Frevert1; Dominik Dannehl2; Lina Jansen3; Silke Hermann3;

Henning Schäer4; Sarah Huwer1; Ingolf Juhasz-Böss1;

Andreas Hartkopf2; Florin-Andrei Taran1

1Department of Obstetrics and Gynecology, University Medical Center Freiburg,

Faculty of Medicine, University of Freiburg, Freiburg, Deutschland

2Department of Women’s Health, Tuebingen University Hospital, Tuebingen,

Deutschland

3Epidemiological Cancer Registry Baden-Württemberg, German Cancer

Research Center (DKFZ), Heidelberg, Deutschland

4Department of Obstetrics and Gynecology, University Clinic Ulm, Faculty

of Medicine, University of Ulm, Ulm, Deutschland

Background: Abemaciclib and ribociclib in combination with endocrine

therapy improve iDFS in patients with HR+/HER2- early breast can-

cer (eBC) at high risk of recurrence. Olaparib improves both iDFS and

OS when given to HER2- eBC patients harboring a BRCA1 or BRCA2

germline mutation. In the MonarchE, NATALEE and OlympiA trials, only

few male patients were included (0.4%, 0.6% and 0.3%, respectively). e

objective of this real-world analysis was to determine the number of men

with eBC meeting the inclusion criteria of these trials.

Methods: We conducted a data inquiry and analysis with the Cancer

Registry of Baden-Württemberg of men with breast cancer diagnosed

between January 1, 2015 and December 31, 2021. Men with eBC were

identied and screened according to the inclusion criteria of the three

above-mentioned trials.

Result: Of 397 men with eBC, 354 (89.1%) had a HR+/Her2- and 4 (1%)

a triple-negative subtype. Of the former, 84 patients (23.7%) fullled the

monarchE and 189 (53.3%) the NATALEE inclusion criteria. Of 358 Her2-

eBC patients, 50 (13.9%) were at clinical high risk according to OlympiA

(2 with TNBC, 48 with HR+/HER2- eBC).

Discussion: In a large real-world sample, more men fulll the inclusion

criteria of monarchE, NATALEE and OlympiA than would be expected in

women. is was due to more advanced stages at diagnosis in men.

Conclusion: Approximately 1 in 4 men with eBC would meet the inclu-

sion criteria of MonarchE, half the patients those for NATALEE and 1 in 7

the high-risk criteria of OlympiA. To observe whether CDK4/6 inhibitors

and PARPi improve prognosis also in men must be the topic of future

(real world) analyses. As we could show, eligible patients exist for these

treatment options.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

956

Immunhistochemical analysis of RUNX3 expression in breast

cancer and RUNX3 characterization in TNBC cell lines

Annika Wendt; Luise Kroll; Olivia Komor; Fabian Munzert; DavitBokhua;

Ingo B. Runnebaum; Norman Haefner

Jena University Hospital, Dept. of Gynecology, Jena, Deutschland

Background: e transcription factor RUNX3 is involved in cell prolif-

eration and dierentiation. e function in breast cancer and its contri-

bution to carcinogenic phenotypes and the disease outcome is not well

described. us, we aimed to analyze the protein expression of RUNX3

in clinical samples and analyzed the phenotypic consequences of gene

expression modulation in TNBC cell lines.

Methods: Immunhistochemical staining for n=87 breast cancer cases

was conducted with the DAKO Real Envision HRP system using anti-

bodies against ERa, ERb, PR, Her2, Ki67 und RUNX3. TNBC cell lines

(HCC1806 – RUNX3+ and MDA-MB-231 – RUNX3-) were transduced

to overexpress (MDA-MB-231) or silence RUNX3 (HCC1806). Cells were

analyzed for cell death and cell cycle distribution (FACS), colony forma-

tion capacity, and cisplatin sensitivity (MTT assay, FACS).

Result: RUNX3 protein expression in tumor cells was detected in the

minority of cases (n=16, 18.4%). However, nearly half of the basal breast

cancer cases expressed RUNX3 (n=13 of 29 cases, 44.8%). us, RUNX3-

positive breast cancers showed signicantly lower ERa, PR and Her2

expression but higher proliferation rate (Ki67). In-vitro characterization

revealed reduced colony formation in both model systems, cell cycle shi

from G2/M to G1/S or vice versa and increased or reduced sensitivity for

Cisplatin aer modulation of RUNX3 gene expression in HCC1806 or

MDA-MB-231, respectively.

Discussion: RUNX3 expressing tumors are enriched in the basal/TNBC

subtype. e colony formation ability of TNBC cell lines with or with-

out RUNX3 expression seems to be adapted to the specic RUNX3

state. However, Cisplatin resistance is potentially mediated by RUNX3

expression.

Conclusion: ese data has to be validated in other TNBC cell lines and

the clinical relevance for basal breast cancer has to be determined.

Disclosure Statement: e authors declare no conict of interest.

Central Nervous System

123

Glycation Leads to Increased Invasion of Glioblastoma Cells

Paola Schildhauer; Christian Scheller; Christian Strauss; Sandra Leisz;

Maximilian Scheer

Universitätsklinikum Halle (Saale), Klinik für Neurochirurgie, Universitätsmedizin

Halle, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland

Background: Glioblastoma (GBM) is a highly aggressive and invasive

brain tumour with poor prognosis despite extensive treatment. A conse-

quence of the glycolytic switch to aerobic glycolysis (Warburg eect) in

these cancer cells, is the increased production of methylglyoxal (MGO) a

potent glycation agent with pro-tumorigenic characteristics. In this study,

we investigated the impact of MGO on GBM and glioma cell invasion and

the ECM proteins involved in these mechanisms.

Methods: We analysed the eect of dierent MGO concentration (0-1

mmol/l) on the cell lines U251, LN229, U343 and human astrocytes (hA).

Cell viability was examined with XTT assays and microscopy. Invasion,

adhesion and chemotactic cell migration were measured with the Real

Time Cell Analyzer (xCelligence). Furthermore, ECM proteins were

examined on mRNA level using qPCR and E- and N-cadherin on protein

level using immunoblotting.

Result: Increasing concentrations of MGO led the accumulation of

advanced glycation end-products and decreased cell viability. e inva-

siveness of the GBM cell lines increased under the inuence of physiolog-

ical MGO concentrations (0.3 mmol/l), whereas the invasive potential of

hA decreased. In addition, glycation had dierential eects on ECM com-

ponents that are involved in the invasion progress, upregulating TGFβ,

brevican and tenascin C in the GBM cell lines LN229 and U251.

Discussion: We could demonstrate that glycation with MGO leads to

increased invasion of glioma and GBM cells, resulting in more aggressive

cell types. In addition, we could show the glycation has cell line specic

eects on ECM expression. Both brevican and tensacin C, which were

foung upregulated in the GBM cell lines aer glycation are commomly

know to aid invasion.

Conclusion: Glycation leads to a more aggressive behavior of glioma

cells. Further studies are necessary to examine the prevention of glyca-

tion as new potential therapeutic strategies such as MGO-scavengers and

Glyoxalase1-activators against glioma and GBM.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts42

124

Glycation interferes with Sialyltransferase Expression of

Glioblastoma Cell Lines and leads to increased Polysialylation

Paola Schildhauer; Christian Scheller; Christian Strauss; Sandra Leisz;

Maximilian Scheer

Universitätsklinikum Halle (Saale), Klinik für Neurochirurgie, Universitätsmedizin

Halle, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland

Background: As known for other tumours, Glioblastoma (GBM) cells pre-

fer aerobic glycolysis for energy production (Warburg eect). is results

in an increase of the reactive by-product Methylglyoxal (MGO), which

leads to irreversible glycation resulting in protein functions’ alterations.

Previous studies have shown that glycation aects polysialylation, another

common characteristic of cancer cells. Polysialylation, which results from

upregulation of sialyltransferases modulates cell-cell-adhesion, invasion

and immune recognition, is marked as a hallmark of cancer.

Methods: e cell lines U251, LN229, U343 and human astrocytes (hA)

were treated with MGO and subsequently sialyltransferase expression was

analysed using qPCR. Polysialylation was examined with immunoblot-

ting. In addition, RNAseq analysis of eight patient primary cultures from

tumours with dierent glioma grades were evaluated on the sialyltrans-

ferase expression prole

Result: e glioma cell lines and primary cultures showed a dierential

gene expression pattern of sialyltransferases. Glycation led to upregula-

tion of all sialyltransferases in the LN229 cell line and ST8SIA4 in the

U251. In contrast, MGO did not aect the sialyltransferase expression

or lead to downregulation in the remaining cell lines. Polysialylation was

detected in the cell lines expressing the corresponding sialyltransferases

and was increased aer glycation in the LN229 and U251.

Discussion: Expression of sialyltransferases showed dierential gene

expression between the cell lines and patient primary cultures, which

could be due to dierent glioma subtypes and genetic background.

Glycation showed cell line specic eects on the expression of sialyltrans-

ferases. Polysialylation was increased aer glycation.

Conclusion: Polysialylation could result in a more aggressive phenotype,

due to the involvement in cancer hallmark processes such as immune eva-

sion, resistance to apoptosis and enhancing invasion.

Disclosure Statement: e authors declare no conict of interest.

125

Synergistic Eects of Combining Tumor Treating Fields with

Nimodipine in Glioma Cells

Konstantin Hauschild; Christian Scheller; Christian Strauss; Sandra Leisz;

Maximilian Scheer

Universitätsklinikum Halle (Saale), Klinik für Neurochirurgie, Universitätsmedizin

Halle, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland

Background: e application of alternating electric elds (TTFields) to

glioblastomas was able to prolong progression-free and overall survival.

Calcium channel activation appears to be a mechanism of action of

TTFields. Nimodipine as a calcium antagonist has so far found its indica-

tion in neurosurgery in the prophylaxis of vasospasm aer subarachnoid

hemorrhage. Our own preliminary work showed a cell type independent

neuroprotective and -regenerative eect in neuronal cells and increased

therapy response of cancer cells. Furthermore, there is evidence of

improved response of selected cell lines to TTFields in combination with

other calcium channel inhibitors.

Methods: Glioma cell lines LN299 (grade 4) and U343 (grade 3) were

used. 5×104 cells pre-treated with 20µmol/l nimodipine were exposed to

TTFields for 24 and 48h using the Inovitro™ system while maintaining the

drug therapy. Subsequently, cell death was analyzed by cell counting with

the Chemotec CellCount and sulforhodamine B assay.

Result: e results showed a 29.3% reduction in cell number (LN229)

with nimodipine therapy and 15.8% with TTFields aer 24h. A combina-

tion of nimodipine and TTFields resulted in a 60.4% reduction in the trial,

For U343, a similar observation was made: -17.6% cells with nimodip-

ine and +12.1% with TTFields therapy only, and the largest reduction

with combination therapy at -27.5% (nimodipine + TTFields). Over the

48-hour period, the values with lower signicance are -2% (nimodipine),

-23.4% (TTFields), and -89% (combination therapy) for cell line LN229

and -50% (nimodipine), -88.9% (TTFields), and -95.5% (combination

therapy) for U343.

Discussion: e combination of TTFields and nimodipine administra-

tion appears to be superior to TTFields therapy alone in terms of cell

death, with not only an additive but also a synergistic eect.

Conclusion: e results indicate that therapy with TTFields and nimodip-

ine could have a positive impact on progression-free and overall survival

in WHO grade 3 and 4 tumours.

Disclosure Statement: e authors declare no conict of interest.

235

Neuroprotective radiotherapy for treatment of brain

metastases – rst results of a pattern-of-care survey in

German-speaking countries

Nils Gleim; Alexander Rühle; Nils Henrik Nicolay; Clemens Seidel

Klinik und Poliklinik für Strahlentherapie, Universitätsklinikum Leipzig, Leipzig,

Deutschland

Background: Within recent years there are increasing options for radio-

therapy (RT) of brain metastases (BM) with optimized neuroprotection.

Stereotactic radiotherapy (SRT) allows sparing of unaected regions even

for multiple BM. Hippocampal-sparing whole brain RT (HS-WBRT) pre-

serves neural stem cells and cognitive function compared to conventional

WBRT. e drug memantine (NMDA receptor antagonist) has shown

indication of improving cognitive function when used concomitant with

HS-WBRT. It is not known to which extent these approaches have become

part of general RT practice in German-speaking countries.

Methods: We performed an online survey among RT centres in

Germany, Austria and Switzerland registered within the German Society

for Radiation Oncology (Deutsche Gesellscha für Radioonkologie,

DEGRO). From April to June 2023, centres were invited to participate in

a survey including 29 questions concerning use of SRT, HS-WBRT and

memantine in RT of BM.

Results: e survey was completed by 78 centres (18.2% of all invited

centres), among them 24 university hospitals, 24 non-university hospi-

tals and 30 outpatient centres. WBRT was treatment of choice starting

from 4-5 BM, 6-10 BM and > 10 BM in 25%, 49%, 26% of centres, respec-

tively. For therapeutic WBRT, hippocampal sparing was used occasion-

ally in 48% and regularly in 26% of centres. For prophylactic WBRT in

SCLC, HS-WBRT was occasionally or regularly used in 21% and 37% of

centres, respectively. 14% of centres reported the concurrent application

of memantine to WBRT. ere were regional dierences and dierences

between dierent types of centres regarding neuroprotective techniques

in RT.

Discussion: A majority of centres uses WBRT in patients with > 5 BM,

and HS-WBRT is used commonly in many centres. In contrast, concur-

rent memantine is only rarely used for RT.

Conclusion: ere is considerable heterogeneity regarding neuropro-

tective RT approaches in patients with BM in German-speaking centres.

Further detailed analyses will be presented.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 43

291

Clinical Implications of DNA Methylation-based Integrated

Classication of Histologically dened Grade 2 Meningiomas

Felix Ehret1; Eilís Pérez2; Siyer Roohani1; David Capper2; David Kaul1

1Charité - Universitätsmedizin Berlin, Department of Radiation Oncology, Berlin,

Deutschland

2Charité - Universitätsmedizin Berlin, Department of Neuropathology, Berlin,

Deutschland

Background: e integration of DNA-methylation analysis with histo-

pathological characteristics and genetic markers enables a more precise

risk stratication and classication of meningiomas. However, the impli-

cations of such a classication for patients suering from grade 2 menin-

giomas, a particular heterogeneous tumor entity, are poorly understood.

We correlate the outcomes of histopathologically conrmed grade 2 men-

ingioma with an integrated molecular-morphologic risk stratication and

determine its clinical implications.

Methods: Grade 2 meningioma patients treated at our institution were

re-classied using an integrated risk stratication and underwent DNA-

methylation and TERT promoter mutation analyses.

Result: Grade 2 meningiomas treated between 2007 and 2021 (n = 123)

were retrospectively analyzed. e median clinical and radiographic fol-

low-up periods were 56.3 and 51.4 months. e distribution of the inte-

grated molecular-morphologic risk groups was as follows: 43 benign

(35%), 62 intermediate (50%), and 18 high-risk (15%). In the multivar-

iable Cox regression analysis, integrated risk groups were signicantly

associated with the risk of local recurrence (hazard ratio (HR) interme-

diate: 5.8, HR high-risk: 6.0, both p < 0.01; vs. low), while resection status

was not (HR gross total resection: 0.46, p = 0.07; vs. subtotal resection).

Only one TERT promoter mutation and one homozygous deletion of

CDKN2A/B were identied.

Discussion: Only around 50% of grade 2 meningiomas have an interme-

diated risk prole. erefore, histopathological assessment alone is not

sucient to adequately assess the biological behavior of meningiomas.

Prospective use of molecular-morphological classiers will be essential

to determine the ecacy of treatments in homogeneous tumor cohorts.

Conclusion: Integrated molecular risk stratication is crucial to guide the

clinical management and counseling of patients with grade 2 meningi-

omas and should be routinely applied to avoid over- and undertreatment.

Disclosure Statement: e authors declare no conict of interest.

349

Characterization of the circadian clock of glioblastoma cell

lines and primary glioblastoma cells: exploring the way to

personalized circadian medicine in glioblastoma

Nina Nelson1; Oliver Heese2; Angela Relógio1

1Institute for Systems Medicine and Faculty of Human Medicine, MSH Medical

School Hamburg, Hamburg, Deutschland

2Department of Neurosurgery and Spinal Surgery, HELIOS Medical Center

Schwerin, University Campus of MSH Medical School Hamburg, Hamburg,

Deutschland

Background: Glioblastoma (GBM) is one of the most lethal tumors types.

Despite eorts to improve GBM therapy success is limited. is calls for

novel innovative therapy concepts. Chronotherapy accounts for the cir-

cadian rhythm of patients and while promising results were reported in

pre-clinical GBM models, clinical studies are contradictory likely due to

neglection of individual clock proles [1].

Methods: Here we characterize the circadian rhythm of GBM cell lines

and primary GBM cells on a cellular, RNA- and protein level and inves-

tigate the eects of clock manipulation via KO or pharmacological inter-

ventions, also at the functional level by measuring proliferation and

cytotoxicity in a Life-Cell Imaging System. Further, we determine the

optimal treatment timepoint of Temozolomide (TMZ) in our system.

Result: We characterized the circadian rhythm of 3 GBM cell lines and

our data showed that pharmacological manipulation of the clock impacted

circadian parameters. ese results will be further investigated using

primary GBM cells, which will allow us to study the circadian rhythm

in a patient-mimicking system. We will use our previously established

time-dependent treatment protocols [2] to establish optimized TMZ-

Chronotherapy regimes in our GBM system.

Discussion: e integration of our experimental data in personalized

mathematical models will allow us to predict optimal treatment times for

GBM.

Conclusion: Personalized circadian medicine has enormous potential in

GBM. Interlocking experimental data with mathematical modelling pro-

vides a way to establish non-invasive measurement of clock parameters as

companion diagnosis for personalized chronotherapy in the future.

References:

1 Petković M, Henis M, Heese O, Relógio A: Chronotherapy in glioblastoma:

State of the art and future perspectives. eBioMedicine (2023) 89.

2 Basti A, Malhan D, Dumbani M, Dahlmann M, Stein U, Relogio A: Core-clock

genes regulate proliferation and invasion via a reciprocal interplay with macc1

in colorectal cancer cells. Cancers (Basel) (2022) 14(14).

Disclosure Statement: e authors declare no conict of interest.

376

Patient-Derived Glioblastoma Explants as a Model for the

Tumor Immune Microenvironment

Zoe Shaked1; Camila Fernández-Zapata2; David Wasilewski1;

Wenbo Sun2; Philip Bischo3; David Horst3; Julia Sophie Onken1;

Mohammad Fardin Gholami4; Thomas Picht1; Chotima Böttcher2;

Peter Vajkoczy1; Ran Xu1

1Department of Neurosurgery, Charité - Universitaetsmedizin Berlin, Berlin,

Deutschland

2Experimental and Clinical Research Center, Charité – Universitaetsmedizin

Berlin, and Berlin Institute of Health and Max Delbrück Center for Molecular

Medicine in the Helmholtz Association, Berlin, Deutschland

3Institute of Pathology, Charité - Universitaetsmedizin Berlin, Berlin,

Deutschland

4Institute of Physics, Humboldt-Universitaet zu Berlin, Berlin, Deutschland

Background: Despite the success of immune checkpoint inhibitors in var-

ious malignancies and promising preclinical results, clinical trials have not

shown a signicant survival benet in glioblastoma (GBM) to date. One

possible reason for this translational failure are the in vitro and in vivo

models used for drug testing, which fail to recapitulate GBM’s complex

biology. Here, we assessed how patient-derived explants (PDEs) preserve

the tumor immune microenvironment (TiME) to evaluate whether they

could serve as a suitable model for bridging the gap between the current

preclinical models and early clinical trials.

Methods: We generated PDEs from six GBM tumors and temporal lobe

tissue of two epilepsy patients and cultured them in an air-liquid-inter-

face setup. e tumor and immune compartments were characterized at

baseline and aer four days of ex vivo culture. Tissue quality was assessed

using H&E staining and apoptosis was tested using TUNEL assay. e

tissue composition and immune landscape were analyzed using immuno-

histochemistry (IHC) and imaging mass cytometry (IMC).

Results: No signicant changes to tissue quality or excessive apoptosis

were observed. Based on the marker expression quantied by IHC and

IMC, the dierent components of the TiME, including extracellular

matrix, immune cells, inammatory and tumor proteins were preserved.

Using IMC, we also identied various host cell populations present in the

TiME and their spatial relationship and demonstrated that the TiME’s

complexity remains intact.

Discussion: Ex vivo cultures of PDEs in GBM are feasible and preserve

histological and immunological characteristics of the TiME and its spa-

tial organization. Replication studies using larger sample sizes and fur-

ther studies using gene expression analyses and functional assays are

warranted.

Conclusion: To further validate the suitability of PDEs for drug testing,

we plan to evaluate the model’s ability to reect pharmacological manipu-

lations, for example through drug uptake studies, and ultimately establish

a pipeline for therapy response prediction.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts44

396

Impact of perioperative Dexamethasone in the context

ofneurosurgical brain metastasis resection

David Wasilewski1; Jan Bukatz1; Ricarda Peukert1; Zoe Shaked1;

Paul Poeser1; Anna-Gila Karbe1; Anna Trelinska-Finger2;

Claudius Jelgersma1; Anton Früh1; Matthias Raspe3; Helena Radbruch4;

David Capper4; Max Schlaak5; Peter Thuss-Patience6; Philip Bischo7;

David Horst7; Marcel Krentzke8; Ran Xu1; Felix Ehret9; David Kaul9;

Martin Misch1; Lars Bullinger6; Nikolaj Frost10; Peter Vajkoczy1;

Julia Sophie Onken1

1Charité Universitaetsmedizin Berlin - Department of Neurosurgery, Berlin,

Deutschland

2Comprehensive Cancer Center Charité, Berlin, Deutschland

3Charite - Department of Neurosurgery, Berlin, Deutschland

4Charité Universitaetsmedizin Berlin - Department of Neuropathology,

Berlin, Deutschland

5Charité Universitaetsmedizin Berlin - Department of Dermatology,

Venerology and Allergology, Berlin, Deutschland

6Charité Universitaetsmedizin Berlin - Department of Hematology,

Oncology and Cancer Immunology, Berlin, Deutschland

7Charité Universitaetsmedizin Berlin - Department of Pathology,

Berlin, Deutschland

8Charité Universitaetsmedizin Berlin - Medical Archive/Zentralarchiv,

Berlin, Deutschland

9Charité Universitaetsmedizin Berlin - Department of Radiooncology,

Berlin, Deutschland

10Charité Universitaetsmedizin Berlin - Department of Infectious Diseases and

Pulmonary Medicine, Berlin, Deutschland

Background: Patients with brain metastases that undergo brain metasta-

sis resection regularly receive perioperative dexamethasone. We sought

to evaluate the impact of cumulative perioperative dexamethasone on

survival.

Methods: Data from brain metastasis patients that underwent neurosur-

gery and associated perioperative daily dexamethasone dosage (13 days

before till 13 days aer surgery) were collected. Cut-o values for cumu-

lative perioperative dexamethasone dose (continuous predictor variable

for survival) were determined using maximally selected rank statistics

and served for later dichotomization (pre- and postoperative: < 281 mg vs

≥ 281 mg). Medical records included baseline radiological, histopatho-

logical, and treatment-related characteristics. Statistical analyses included

Kaplan-Meier, Cox proportional hazards regression for overall survival

with adjustment for potential confounders including age, gender, extrac-

ranial metastases, edema volume, brain metastasis burden, pre-treatment

status as well as adjuvant treatment.

Result: 539 patients were included. Median follow-up time was 58,97

months. Aer adjusting for potential confounders patients with higher

cumulative perioperative dexamethasone (≥281 mg) showed shorter sur-

vival (HR: 1.35 (1.02-1.79, p=0.034) as compared to patients with lower

cumulative doses (<281 mg).

Discussion: Cumulative perioperative dexamethasone is linked to

decreased survival in resected brain metastases. Strict dosage, down taper

or methods reducing corticosteroid dependency should be regularly eval-

uated in clinical practice in patients with brain metastases.

Conclusion: is large single-center study suggests that in patients under-

going brain metastasis resection dexamethasone dosage should regularly

be evaluated in terms of dosing and down tapering given potential side

eects or potential impact on outcome when administered in high doses

over several weeks perioperatively.

Disclosure Statement: e authors declare no conict of interest.

414

Impact of the COVID-19 pandemic on incidence and therapy

of high-grade gliomas

Vitaly Sokotukhin1; Michael Gerken2; Monika Klinkhammer-Schalke3;

Armin Pauer2

1Hospital Barmherzige Brueder Regensburg, Regensburg, Deutschland

2Tumorzentrum Regensburg, Institut für Qualitätssicherung und

Versorgungsforschung der Universität Regensburg, Regensburg, Deutschland

3Bayerisches Krebsregister, Regionalzentrum Regensburg, Bayerisches

Landesamt für Gesundheit und Lebensmittelsicherheit (LGL), Nürnberg,

Deutschland

Background: e COVID-19 pandemic has aected neuro-oncology ser-

vices around the world. Our objective was to determine the inuence of

the COVID-19 pandemic on the incidence, grade shi, therapy and delay

of the therapy of high-grade gliomas (HGG).

Methods: Based on data of the population-based clinical cancer registry

Regensburg, pandemic years 2020 and 2021 were compared with years

2015-2019.

Result: During the investigation period from 2015 to 2021 1008 patients

with an initial diagnosis of glioma (ICD-10 diagnosis C71) were analysed.

WHO grade 3 and 4 tumors requiring urgent treatment comprised 142

(14,1%) and 744 (73,8%) patients, respectively. e analysis of the annual

number of newly diagnosed cases from 2015 to 2021 showed no clear

dierence between the years before and during the pandemic. In March

and October 2020 a not statistically signicant decrease of new cases of

37,5% (March) and 35,5% (October) compared to the comparison months

2015-2019 was observed. e portion of WHO grade 4 tumors remained

stable over the course of the study. e number of newly diagnosed WHO

grade 4 brain tumors in 2020 (73,7%, p=0,911) and 2021 (75,3%, p=0,597)

remained comparable to the number in the study period 2015–2019

(73,2%). A monthly analysis of the number of operations on gliomas

WHO grade 3 and 4 in 2020 vs. 2015–2019 showed a signicant decrease

until the middle of the year 2020. e number of operations increased rap-

idly in July 2020. e quarterly comparison 2020 vs. 2015–2019 showed a

statistically signicant decrease in surgeries in patients with WHO grade

3 and 4 gliomas in the rst and second quarter of 2020.

Conclusion: With the exception of a decrease in the number of surgical

interventions in the rst quarter of 2020, we have not identied any sig-

nicant changes in the diagnosis and treatment of HGG during the pan-

demic, as was seen in patients with other cancers, for example colorectal

and breast cancer.

Disclosure Statement: e authors declare no conict of interest.

610

Epilepsy-associated glioblastoma MRI characteristics

andbrain regions at primary diagnosis across a large

patientcohort

Yeong Chul Yun1,2,3; Katharina Holz1,2; Sabine Wolf1,2; Freya Garhöfer1,2;

Philipp Vollmuth2; Martin Bendszus2; Sabine Heiland2; Wolfgang Wick4;

Varun Venkataramani4,5; Felix T. Kurz2,3

1Faculty of Medicine, Heidelberg University, Heidelberg, Deutschland

2Department of Neuroradiology, Heidelberg University Hospital, Heidelberg,

Deutschland

3Division of Radiology, German Cancer Research Center (DKFZ), Heidelberg,

Deutschland

4Department of Neurology, Heidelberg University Hospital, Heidelberg,

Deutschland

5Department of Functional Neuroanatomy, Heidelberg University, Heidelberg,

Deutschland

Background: Identifying brain regions where glioblastoma (GBM) is

associated with epilepsy and characterizing brain tumor characteristics

could help recognize patients with a higher risk of seizures based on mag-

netic resonance imaging (MRI).

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 45

Methods: 642 patients (no epilepsy: 469, with epilepsy: 173) with de novo

GBM received 3 Tesla MRI, including T1-weighted (T1w) images before

and aer Gadolinium contrast administration. Contrast-enhancing

tumors (CE) were segmented semi-automatically from post-contrast

T1w images. Lesion volumes obtained from segmented masks were com-

pared using Mann-Whitney U tests. Images and masks were registered

to MNI-152-space. A voxel-wise Fisher-exact test followed by random

permutation analysis (ADIFFI) for multiple comparison correction were

performed to identify regions with higher/lower occurrence of epilep-

sy-associated tumors.

Result: e CE lesion volume associated with epilepsy was signicantly

smaller than lesions without epilepsy (5.8 ml ± 0.9 ml vs. 19.9 ml ± 0.9ml;

p<0.0001). Regions, where epilepsy-related lesions were signicantly

more frequent, could not be found with ADIFFI. However, ADIFFI clus-

ters were found in subcortical regions and in white matter (WM) around

the thalamus, where occurrence of lesions without epilepsy was higher,

suggesting a preference for grey matter (GM) in epilepsy-related lesions.

Discussion: e heterogeneous distribution of epilepsy-associated lesions

and preference of GM is in accordance with previous studies. However,

the volume of symptomatic lesions was smaller, signifying that location

and/or fraction of GM vs. WM in tumor composition may be more

important than tumor size.

Conclusion: GBM lesion located in subcortical regions are less associated

with epilepsy. In cortical regions, the association of lesions with epilepsy

was indeterminate according to ADIFFI analysis.

Disclosure Statement: e authors declare no conict of interest.

729

Gliosarcoma – Clinical outcomes and prognostic

factors – Aninternational multi-institutional analysis

Siyer Roohani1,2,3; Maximilian Mirwald1; Felix Ehret1,3;

Soleiman Fabris Roohani1; Jana Käthe Strieer4; Noelle Samira Jacob4;

Enrico Pozzo5; Alessandra Gonnelli6; Camilla Satragno7; Ilinca Popp8,9;

Johannes Steel8; Jolina Handtke1; Noa Marie Claßen1; Titus Rotermund1;

Daniel Zips1,3; Peter Vajkoczy10; Ulrich Schüller11,12,13;

Mateusz Jacek Spałek14; David Kaul1,3

1Charité − Universitätsmedizin Berlin, Klinik für Radioonkologie und

Strahlentherapie, Berlin, Deutschland

2Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Berlin,

Deutschland

3Deutsches Konsortium für Translationale Krebsforschung (DKTK), Deutsches

Krebsforschungszentrum (DKFZ), Partnerstandort Berlin, Berlin, Deutschland,

Berlin, Deutschland

4Universitätsklinikum Hamburg-Eppendorf, Zentrum für Onkologie, II.

Medizinische Klinik und Poliklinik, Hamburg, Deutschland

5Department of Radiotherapy, Istituto Oncologico Veneto IOV-IRCCS, Padua,

Italy; Department of Medicine-DIMED, University of Padua, Padua, Italien

6Radiation Oncology Unit, Azienda Ospedaliero Universitaria Pisana, Pisa, Italien

7Department of Experimental Medicine (DIMES), University of Genoa, Genua,

Italien

8Universitätsklinikum Freiburg, Klinik für Strahlenheilkunde, Freiburg,

Deutschland

9Deutsches Konsortium für Translationale Krebsforschung (DKTK),

Partnerstandort Freiburg, Freiburg, Deutschland

10Charité − Universitätsmedizin Berlin, Neurochirurgische Klinik, Berlin,

Deutschland

11Universitätsklinikum Hamburg-Eppendorf, Klinik für Pädiatrische Hämatologie

und Onkologie, Hamburg, Deutschland

12Universitätsklinikum Hamburg-Eppendorf, Forschungsinstitut

Kinderkrebszentrum Hamburg, Hamburg, Deutschland

13Universitätsklinikum Hamburg-Eppendorf, Institut für Neuropathologie,

Hamburg, Deutschland

14Maria Sklodowska-Curie National Research Institute of Oncology, Department

of Radiotherapy, Warschau, Polen

Background: is study sought to describe oncological outcomes and

investigate prognostic factors for patients with gliosarcoma (GSM).

Methods: Histopathologically conrmed GSM patients who received

treatment at seven European institutions were included and retrospectively

analyzed. Overall survival (OS) and progression-free survival (PFS)

were assessed using the Kaplan-Meier estimator. Multivariable Cox

regression analysis (MVA) was performed to identify factors associated

with OS and PFS.

Results: We included 159 patients with a median follow-up time of

8.6months. e majority received surgery (94.3%), postoperative radio-

therapy (pRT, 78.6%), and temozolomide (TMZ)-based postoperative che-

motherapy (65.4%). e median OS and PFS were 12.0 and 6.1 months,

respectively. At 6-month, 1-year and 2-year, OS was 72.5%, 50.8% and

22.1%, while PFS was 51.5%, 24.8% and 8.3%. In the MVA, the following

factors were signicantly associated with OS: age (hazard ratio (HR): 1.03,

p=0.008), biopsy only vs. gross total resection (HR: 10.0, p=0.003), pRT

vs. no RT (HR: 0.34, p=0.008), postoperative TMZ-based chemotherapy

vs. no chemotherapy (HR: 0.37, p=0.002), and MGMT promoter status

non-methylated vs. methylated (HR: 2.54, p=0.003). Subtotal resection,

TP53 mutational status, and tumor size were not signicantly associated

with OS. For PFS, the following factors were signicantly associated in

the MVA: biopsy only vs. gross total resection (HR: 4.30, p=0.034), TMZ-

based chemotherapy vs. no chemotherapy (HR: 0.30, p<0.001), MGMT

promoter status non-methylated vs. methylated (HR: 2.62, p=0.001).

Subtotal resection, TP53 mutational status, and tumor size were not sig-

nicantly associated with PFS.

Discussion: e intrinsic limitations to a retrospective study design must

be considered.

Conclusion: Aggressive trimodal therapy comprising surgical excision,

pRT and TMZ-based chemotherapy remain essential for oncological out-

comes, while younger age and methylated MGMT promoter status are

associated with improved survival.

Disclosure Statement: e authors declare no conict of interest.

742

Eects of Traditional Chinese Medicine (TCM) and Western

Naturopathy on survival of patients with glioblastoma

Susanne Roth-Goldbrunner1; Marco Timmer2; Charlotte Nettekoven2;

Martin Kocher3; Roland Goldbrunner2

1Klinik für Innere Medizin 1, Centrum für Integrierte Onkologie,

Universitätsklinik Köln, Köln, Deutschland

2Klinik für allgemeine Neurochirurgie, Zentrum für Neurochirurgie,

Neuroonkologisches Tumorzentrum, Universitätsklinik Köln, Köln, Deutschland

3Klinik für Stereotaktische und Funktionelle Neurochirurgie, Zentrum für

Neurochirurgie, Neuroonkologisches Tumorzentrum, Universitätsklinik Köln,

Köln, Deutschland

Background: Glioblastomas (WHO CNS grade 4) are malignant brain

tumors with a median overall survival of 15-18 months aer standard

therapy consisting of surgical resection, radiation and chemotherapy.

erefore there is a great need for therapeutic options in addition to

standard treatment. Aim of this study is to analyze the eects of comple-

mentary TCM and Western Naturopathy on progression-free survival and

overall survival.

Methods: We compared 23 patients who were treated with TCM and

Western Naturopathy in addition to standard therapy (complementary

group) with a control group of 23 patients receiving standard therapy only

(control group) who were matched according to known risk factors like

age, tumor markers (IDH mutation status, MGMT promotor methylation),

Karnofsky Performance Status and resection status (complete, incomplete).

Result: In our preliminary results the progression-free survival of the

complementary group (21.4 ± 6.9 months) was longer than that o the

control group (10,7 ± 1,3 months), but without reaching statistical signi-

cance (p = 0,073). In contrast, the overall survival was signicantly longer

in the complementary group (31,0 ± 6,7 months) compared to the control

group (17,8 ± 1,3 months; p = 0,011).

Discussion: Explanatory power of results is limited by the retrospective

study design and the small sample size. We tried to overcome this limi-

tations by appropriate matching using a large patient data pool from our

DKG certied Neurooncology Center.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts46

Conclusion: Complementary treatment with TCM and Western

Naturopathy seems to have a strong impact on overall survival of glioblas-

toma patients. is statement has to be conrmed by a prospective study

with a larger patient cohort.

Disclosure Statement: e authors declare no conict of interest.

804

Patient experience using Tumor Treating Fields (TTFields)

therapy for glioblastoma

Eleni Batzianouli1; Ksenia Finogenova2; Healther Johnson3;

Huda Ismail Abdullah3

1Novocure GmbH, Root, Schweiz

2Novocure GmbH, Munich, Deutschland

3Novocure Ltd, New York, USA

Background: TTFields are electric elds that disrupt key cancer cell sur-

vival processes. TTFields therapy is FDA-approved and CE-marked for

the treatment of newly diagnosed and recurrent glioblastoma (GBM).

Methods: Questionnaires (independently developed and administered)

were distributed by mail and online in Germany, Austria, and Switzerland

to patients/caregivers (on patient’s behalf) using TTFields (Optune;

Novocure GmbH, device manufacturer) as therapy for GBM.

Result: Between January 1, 2022, and December 31, 2022, 545 patients/

caregivers (43%) returned surveys; 43% new starters (≤2 months), 36%

short-term users (≤6 months), and 21% long-term users (>6 months).

e sex of new starters (male: 66%) and long-term users (male: 59%), as

well as age of new starters (≥60 years: 54%) reected the expected inci-

dence of the disease population. Most respondents adapted well to the

device and were satised/very satised with TTFields therapy use (new

starters: 82%; short-term users: 68%; long-term users: 67%). Most short-

term users (79%) could integrate the therapy into their daily life in <4

weeks. Most long-term users (63%) indicated that TTFields therapy use

required changes to their daily life. Respondents reported skin irritation

and device handling. Most long-term users (74%) and short-term users

(68%) would recommend TTFields therapy to others with GBM. Most

patients rated device handling as easy (long-term users: 82%; short-term

users: 78%), with good sleep being achieved by most patients (long-term

users: 77%; short-term users: 72%). In-person guidance from ‘Device

Support Specialists’ was important to 88% and 89% of short- and long-

term users, respectively.

Discussion: is assessment helped dene unmet needs to treatment and

encourages patient support services and communication with health car-

egivers and patients.

Conclusion: Most patients receiving TTFields therapy for GBM were

highly satised with the treatment and would recommend it to others.

Longer patient experience with use of TTFields therapy seemed to miti-

gate barriers to treatment.

Disclosure Statement: e authors declare the following: All authors are

employees and hold stock in Novocure.

806

Connecting the Dots - the Role of Connexins in Glioblastoma

Communication

Hannah Strobel1; Georg Karpel-Massler2; Aurelia Peraud2;

Klaus-Michael Debatin1; Mike-Andrew Westho1

1Department of Pediatrics and Adolescent Medicine, University Medical Center

Ulm, Ulm, Deutschland

2Department of Neurosurgery, University Medical Center Ulm, Ulm,

Deutschland

Background: Tumors form complex ecological niches in which individual

cells communicate with their microenvironment. Glioblastoma (GB) cells,

for instance, form long membrane protrusions that are connected to each

other via gap junctions (GJ), which are intercellular channels composed

of connexins (Cx). ese channels allow the exchange of small molecules

and ions (Ca2+). ereby, GJs/Cxs connect GB cells to huge communicat-

ing networks that are more resistant to therapy and support tumor growth

and migration. In this study, we investigated the precise Cx composition

of brain tumors with a particular focus on GB and investigated their func-

tional role.

Methods: A panel of 28 dierent patient-derived stem cell-like brain

tumor cells (SCs) and two patient-derived non-tumor primary cells were

screened for the expression of all 21 known Cxs. By comparing our nd-

ings with publicly available RNA sequencing data and performing various

in silico analyses, we identied interesting candidates. ese were further

investigated by dierent biochemical and genetic approaches - knock-out

cells were generated and analyzed with regard to cell growth, cell death,

and their capability to form morphological networks.

Results: In the present study, we found that therapeutic modulation of

GJs strongly aects the cellular behavior of primary GB cells, conrming

that primary patient material is a suitable model. Interestingly, a con-

siderable multiplicity of Cx mRNAs are expressed. Cx26 was identied

as an interesting candidate as increased expression levels are found in

grade 4 brain tumors and correlate with signicantly shorter survival.

Further, Cx26 was mainly expressed in cells of the tumor core. While

the knock-out of Cx26 does not impact cell growth and spontaneous cell

death in SCs in vitro, it does aect their capability to form morphological

networks.

Conclusion: Primary patient material-derived cells are a suitable model

to study the role of GJs/Cxs in vitro and suggest that Cx26 is involved in

GB connectivity.

Disclosure Statement: e authors declare no conict of interest.

861

NANO scale associated with de novo Glioblastoma lesion

sizeand location

Yeong Chul Yun1,2,3; Sabine Wolf1,2; Katharina Holz1,2; Freya Garhöfer1,2;

Philipp Vollmuth2; Martin Bendszus2; Sabine Heiland2; Wolfgang Wick4;

Felix T. Kurz2,3; Varun Venkataramani4,5

1Faculty of Medicine, Heidelberg University, Heidelberg, Deutschland

2Department of Neuroradiology, Heidelberg University Hospital, Heidelberg,

Deutschland

3Division of Radiology, German Cancer Research Center (DKFZ), Heidelberg,

Deutschland

4Department of Neurology, Heidelberg University Hospital, Heidelberg,

Deutschland

5Department of Functional Neuroanatomy, Heidelberg University,

Heidelberg, Deutschland

Background: Neurologic Assessment in Neuro-Oncology (NANO) eval-

uates neurologic decits in nine domains based on simple clinical exam-

ination. We aim to correlate clinical and radiological ndings to improve

diagnostic evaluation of glioblastoma (GBM) patients.

Methods: We evaluated 3-Tesla magnetic resonance images (MRI) with

Gadolinium contrast administration from 643 patients with de novo

GBM. Neurological decits were assessed according to the NANO scale.

Contrast-enhancing tumor (CE) was segmented semi-automatically from

post-contrast T1-weighted MRIs. Lesion volumes from patients without

any NANO-score relevant decits were compared with symptomatic

patients in at least one domain using Mann-Whitney U tests. Images were

registered to MNI-152-space. Voxel-wise Fisher-exact-test followed by

random permutation analysis (ADIFFI) for multiple comparison correc-

tion was performed to identify regions with higher occurrence of tumors

associated with the decits. ADIFFI was performed for each domain of

NANO: gait, strength, ataxia, sensation, visual elds, facial strength, lan-

guage, level of consciousness and behavior.

Result: ere was a signicant correlation between NANO and CE lesion

volume (r = 0.30, p<0.0001). e volume of CE associated without any

decits (n=157, 5.6 ml ± 1.3 ml) was signicantly smaller (p<0.0001)

than lesions with decits (n=486, 18.9 ml ± 0.9 ml). For each investigated

domain with the NANO scale, radiologically correlated brain regions

could be identied with ADIFFI.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 47

Discussion: We nd a clear association between NANO scale and GBM

lesion size and location, in line with other works using symptom lesion

mapping.

Conclusion: NANO scale may provide an estimate of GBM lesion vol-

ume. In addition, for certain domains of the NANO, neurological decits

are well associated with GBM location. ese ndings suggest further

investigations into the correlation between NANO and RANO criteria

over time and their usefulness in the clinical management of GBM.

Disclosure Statement: e authors declare no conict of interest.

867

Radiogenomic analysis of a large glioma patient cohort

Varun Venkataramani1,2; Yeong Chul Yun3,4,5; Freya Garhöfer3,4;

Sabine Wolf3,4; Katharina Holz3,4; Philipp Vollmuth4; Martin Bendszus4;

Sabine Heiland4; Wolfgang Wick2; Felix T. Kurz4,5

1Department of Functional Neuroanatomy, Heidelberg University, Heidelberg,

Deutschland

2Department of Neurology, Heidelberg University Hospital, Deutschland

3Faculty of Medicine, Heidelberg University, Heidelberg, Deutschland

4Department of Neuroradiology, Heidelberg University Hospital, Heidelberg,

Deutschland

5Division of Radiology, German Cancer Research Center (DKFZ), Heidelberg,

Deutschland

Background: e objective of this research is to assess the correlation

between brain tumor location and genomic alterations with a voxel-wise

Fisher-exact-test followed by random permutation analysis (ADIFFI) in

glioblastoma (GBM), astrocytoma and oligodendroglioma patients.

Methods: We evaluated 3-Tesla MR images with Gadolinium contrast

administration from 643 patients with de-novo GBM and 98 patients

with low-grade glioma (59 astrocytoma, 39 oligodendroglioma). ADIFFI

with multiple comparison correction was performed to identify regions with

higher occurrence of tumors associated with both methylation groups of

GBM (RTKI: 100; RTKII: 187; mesenchymal: 183) and for comparisons

between GBM and low-grade glioma. Lastly, the occurrence between

IDH-mutated, 1p/19q-codeleted oligodendroglioma and IDH-mutated,

non 1p/19q-codeleted astrocytoma was compared using ADIFFI.

Result: ere was a signicant correlation between the occurrence of oli-

godendroglioma and astrocytoma as compared to GBM with a predom-

inance in the frontal lobe adjacent to the rostral extension of the lateral

ventricles. Further analyses with ADIFFI did not reveal any dierences

in tumor location between astrocytoma and oligodendroglioma. Lastly,

all analyzed methylation groups of GBM were not signicantly correlated

with any specic brain region.

Discussion: We have analyzed the largest radiogenomic patient cohort

consisting of GBM, astrocytoma and oligodendroglioma. Our ndings are

in line with previously analyzed smaller patient cohorts. We were not able

to nd small dierences within our GBM patient cohort and furthermore

could not reveal dierences between subtypes of low-grade glioma. is

would be in line with a preferential glioma location associated with an

IDH-mutation from other groups.

Conclusion: ese radiogenomic analyses underline the importance of

the IDH-mutation for determining tumor location and potentially point

to a cell of origin along the rostral extension of the lateral ventricles.

Disclosure Statement: e authors declare no conict of interest.

945

Intraindividual hormone receptor heterogeneity in patients

with brain metastasis from breast cancer: Gain of Her2

receptor from primary tumor to brain metastasis correlates to

worsened survival

Muriel Heimann1; Anna-Laura Pottho1; Lea L. Friker2; Valeri Borger1;

Ulrich Herrlinger3; Hartmut Vatter1; Klaus Kuchelmeister2; Patrick Schuss1,4;

Matthias Schneider1

1Department of Neurosurgery, Rheinische Friedrich-Wilhelms-University

Hospital, Bonn, Deutschland

2Department of Neuropathology, Rheinische Friedrich-Wilhelms-University

Hospital, Bonn, Deutschland

3Division of Clinical Neurooncology, Department of Neurology, Rheinische

Friedrich-Wilhelms-University Hospital, Bonn, Deutschland

4Department of Neurosurgery, BG Klinikum Unfallkrankenhaus Berlin, Berlin,

Deutschland

Background: Deciphering the dynamics of intraindividual tumor het-

erogeneity is supposed to more precisely predict long-term outcome in

patients with advanced stages of cancer. In patients with brain metasta-

sis (BM) from breast cancer (BC), intraindividual tumor heterogeneity

is partly driven by hormone receptor conversion between the tumor of

primary site and the BM. e aim of the present study was to evaluate the

prognostic impact of hormone receptor conversion in patients that had

undergone surgery for BM from BC.

Methods: Between 2013 and 2019, 42 patients were surgically treated

for BM derived from BC at the authors neuro-oncological center. Tumor

receptor status (estrogen receptor (ER), progesterone receptor (PR) and

Her2/neu) was assessed histopathologically for the tumor of primary site

and the BM. A multivariable analysis was performed in order to identify

predictors of worsened survival.

Results: Median overall survival for the entire study cohort was 17 months.

Overall, hormone receptor conversion was found in 15 of 42 patients

(36%). Loss of ER and PR was present in 8 of 42 patients (19%), respec-

tively. Gain of Her2/neu was present in 7 patients (17%). Multivariable

analysis revealed gain of Her2/neu as an independent negative prognostic

predictor for increased one-year mortality (Odds ratio 0.1, 95% con-

dence interval 0.01-0.7, p=0.027).

Conclusions: e present study indicates that gain of HER2/neu from

tumor of primary site to BM is associated with elevated one-year mortality

rates and worsened overall survival in patients with BM derived from BC.

Disclosure Statement: e authors declare no conict of interest.

Endocrine Tumors

Organoid-associated resistance to antibody-based therapyin

vitrois associated with reduced internalization

Helena Lucius1; Kerstin Wendland1; Anna Ammon1,2; Susanne Pfeer3;

Christian Pilarsky3; Andreas Mackensen1; Fabian Müller1

1Department of internal medicine 5, hematology and oncology; university

hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nürnberg

(FAU), Erlangen, Deutschland

2Department of Hematology and Oncology, Medical Faculty, University of

Augsburg, University Hospital Augsburg, Augsburg, Deutschland

3Department of Surgery, university hospital of Erlangen, Friedrich-Alexander

University of Erlangen-Nürnberg (FAU), Erlangen, Deutschland

Background: Neuroendocrine tumors (NET) are a subgroup of neu-

roendocrine neoplasms with limited systemic treatment options in

advanced stage.1 An interesting novel therapeutic approach is the induc-

tion of unfolded protein response using PERK inhibitors,2 which may

induce synergy in combination with a block of protein synthesis by

immunotoxin Hb21.3

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts48

Methods: We used NCI-H720 (lung) and Bon-1 (pancreas) NET cell

lines in monolayer and organoid culture.4 Cells were treated with PERK-

inhibitor, Hb21 or both. Cytotoxicity, surface binding, and internalization

were determined by ow cytometry.

Results: Hb21 induced dose-dependent cell death in NET-monolayer.

Organoids however were resistant to Hb21 treatment. While strong syn-

ergy of Hb21 and PERK-inhibition was found in monolayer, this eect

was absent in organoids. Investigation of resistance to Hb21 revealed that

organoid-specic culture medium (hCPLT) induced similar resistance in

monolayer. Mechanistically, we excluded reduced drug target expression

and target binding as explanations. In contrast, internalization assays

revealed reduced cellular uptake of Hb21.

Discussion: Our results question the role of hCPLT in the use of organoid

cultures when assessing ecacy of therapeutic antibodies. Numerous

components of hCPLT inuence resistance to immunotoxins, suggesting

more than one mechanism of resistance. Reduced internalization may

similarly aect other antibody-based therapies.

Conclusion: e use of organoids as a substitute for in vivo models must

be evaluated with caution. For immunotoxins and possibly for other anti-

body-based therapies, organoids may not be a clinically relevant model.

Indication of source:

1 Scarpa, A. et al. Nature (2017).

2 Moore, P. C. et al.Cancer Res (2019).

3 Gsottberger, F. et al. Cell Death Dis (2023).

4 Baker, L. et al. Tuveson laboratory murine and human organoid protocol

(2017) www.tuvesonlab.labsites.cshl.edu/ (accessed 08/23).

Disclosure Statement: e authors declare the following: FM received Research

Support from MedImmune and Honoraria from AstraZeneca. All other authors do

not have any conict interest.

Epidemiology

236

Causes of death among patients with cancer from

2013 to 2020: A population-based study

Charlotte Gedenk1,2; Anita Feller1; Volker Arndt1,3

1Epidemiological Cancer Registry Baden-Württemberg, German Cancer

Research Center (DKFZ), Heidelberg, Deutschland

2Medical Faculty of Heidelberg, University of Heidelberg, Heidelberg,

Deutschland

3Unit of Cancer Survivorship, German Cancer Research Center (DKFZ),

Heidelberg, Deutschland

Background: Cancer accounts for 22% of all deaths in Germany [1]. With

improving survival rates it is to be expected that other competing causes

of death among cancer patients will become more relevant.

Methods: e mortality pattern of cancer patients was examined using

data from the Cancer Registry of Baden-Württemberg (2013-2020).

Standardized mortality ratios (SMRs) were calculated to assess the

cause-specic mortality in cancer patients in comparison to the general

population.

Result: Out of 144 949 deceased cancer patients 16,2% died from a non-

cancer death (median follow-up [FU] time: 0.87 years). Most frequent

causes were death by ischemic heart disease (17,8%) and other cardio-

vascular diseases (CVD) (18%). In comparison to the general population,

cancer patients were more likely to die from infections (SMR 1.56 [95%-

CI 1,46-1.65]), liver diseases (SMR 2.02 [CI 1.90-2.14]) and suicide (SMR

1.94 [CI 1.76-2.11]). SMRs varied by cancer site with highest SMRs in

lung cancer, especially for CVD and pulmonary diseases. For most tum-

ors, highest SMRs were found in young patients and patients within the

rst year of FU.

Discussion: To our knowledge, this ist the rst study using German data

to examine the risk for noncancer causes of death in oncological patients.

Previous international analyses already reported an increased noncancer

mortality in cancer patients in comparison to the general population.

ese patterns might reect potential therapy related late eects but also

shared risk factors for cancer and other diseases.

Conclusion: Although cancer remains the most frequent cause of death in

oncological patients within the rst years aer diagnosis, cancer patients

are at increased risk regarding competing causes of death such as infec-

tions and suicide. is pattern suggests that an increased awareness of

other competing causes of death in cancer FU and survivorship care

might be warranted.

Indication of source:

1. Statistisches Bundesamt (Destatis). Causes of death by type of disease, 2021.

Disclosure Statement: e authors declare no conict of interest.

249

Epidemiology of malignant pleural mesothelioma in the

federal state of Hesse – a population-based analysis

Isabelle Finke; Soo-Zin Kim-Wanner

Hessisches Krebsregister, Hessisches Landesamt für Gesundheit und Pege,

Frankfurt am Main, Deutschland

Background: Current epidemiologic data of malignant pleural mesothe-

lioma (MPM) are sparse for Germany. e present analysis gives an over-

view of incidence, mortality and prevalence of MPM in the federal state

of Hesse.

Methods: We used data of patients diagnosed with MPM (ICD-10 C45.0)

from the Hessian cancer registry. Crude and age-standardized (old

European standard) incidence and mortality were calculated stratied

by sex and age for the years 2015-2020. Additionally, 1-, 3- and 5-year

prevalence and distributions of cases by morphological subtypes were

computed.

Result: During the six years observation period 552 patients were diag-

nosed and 470 patients died with a diagnosis of MPM. For 2015-2020,

age-standardized incidence for women and men was 0.2 and 1.4 per

100.000, and mortality reached 0.2 and 1.2 per 100.000 for women and

men, respectively. e female to male ratio for incident cases was 1:4. e

1-year prevalence for 2020 was 0.5 and 2.5 per 100.000, 3- year prevalence

for 2018-2020 was 0.8 and 4.4 per 100.000 and 5-year prevalence for 2016-

2020 was 1.0 and 5.1 per 100.000 for women and men, respectively. Both

sexes had a median age at diagnosis of 77 years and median age at death

was 79 years for men and 78 years for women. e proportion of patients

only registered by death certicate (DCO) was high (women: 20.4%, men:

21.6%). For both sexes, the most frequently diagnosed morphologic sub-

type was epithelioid MPM (Epithelioid MPM: women 66.2%, men 54.7%;

biphasic MPM: women 9.5%, men 6.7%; sarcomatoid MPM: women 4.1%,

men 6.1%; MPM not otherwise specied: women 20.3%, men 32.5%).

Discussion: is is the rst analysis showing epidemiologic data of MPM

for the federal state of Hesse. Due to the high proportion of DCO cases,

a survival analysis was not possible. However, the comparison between

mortality and incidence might suggest a poor prognosis compared to

other cancers, which is in line with previous studies.

Conclusion: Our overview showed that MPM is a rare tumour, which

more frequently aects men and patients in advanced age.

Disclosure Statement: e authors declare no conict of interest.

357

Epidemiology of cervical cancer in elderly women in Germany

Sonja Neumeyer; Luana Fiengo Tanaka; Stefanie Klug

Chair of Epidemiology, Department of Sport and Health Science, Technical

University of Munich, Munich, Deutschland

Background: Evidence suggests that the incidence of cervical cancer in

elderly women could be underestimated. Elderly women are more oen

diagnosed with advanced-stage disease and have inferior outcomes com-

pared to younger patients. We investigated incidence, treatment and sur-

vival of cervical cancer in elderly women in Germany.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 49

Methods: e incidence rates of cervical cancer were determined using

data of six federal state cancer registries. Elderly women were dened as

65 years of age and older and compared to younger women. Incidence

was investigated uncorrected and corrected for hysterectomy prevalence

rates. Distribution of treatment modalities such as surgery, chemotherapy,

and radiation therapy were assessed. 5-year relative survival was estimated

using the period approach. Survival was stratied by tumor stage and his-

tological type. Multivariable Cox proportional hazard models were cal-

culated to compare overall survival between younger and elderly women.

Result: In total, 14 528 cervical cancer cases were included in the analyses

with an age range from 20 to more than 85 years of age. Of those, nearly

30% were elderly women aged 65 years or older. Hysterectomy correction

showed that incidence rates were underestimated up to 70% in the oldest

age groups. A lower proportion of elderly women was treated with sur-

gery or chemotherapy. is was found especially in more advanced tumor

stages. Younger patients had a much better 5-year relative survival com-

pared to elderly patients.

Discussion: Cervical cancer incidence in elderly women is underesti-

mated and survival is lower compared to younger women in Germany.

Conclusion: Due to the high disease burden, screening strategies for

elderly women need to be improved.

Indication of source:

1 Neumeyer S, Tanaka LF, Liang LA, Klug SJ. Epidemiology of cervical cancer

in elderly women: analysis of incidence, treatment and survival using German

registry data. Cancer Medicine. 2023; doi: 10.1002/cam4.6318.

Disclosure Statement: e authors declare no conict of interest.

410

Epidemiological study on the occurrence of tumor diseases

among employees of the Ihlenberg landll site

Kirsi Manz; Kerstin Weitmann; Sarah Theen; Gabriele Robers;

WolfgangHomann

Krebsregister Mecklenburg-Vorpommern am Institut für Community Medicine

der Universitätsmedizin Greifswald, Greifswald, Deutschland

Background: Employees at the Ihlenberg toxic waste landll in

Mecklenburg-Vorpommern (MV), which borders Schleswig-Holstein

(SH), were found to be at increased risk of cancer and death from cancer

in a previous cohort analysis covering the years 1983 to 2006. An update

aer two more years showed that the risk was trending downward. Among

other measures, a comprehensive occupational health management pro-

gram was initiated to further protect employees. e continuation of the

study presented here aimed to quantify cancer risk and total mortality in

the employee cohort in recent years using cancer registry data.

Methods: Data on incident cancers among employees were obtained by

linkage with the cancer registries of MV and SH, and data on employee

deaths were obtained from civil registries. Standardized incidence ratios

(SIR) for cancers and standardized mortality ratios (SMR) were calculated

to quantify cancer and mortality risk in the employee cohort. In addition,

the impact of employment duration and latency periods up to 30 years

were considered.

Result: e cohort of 590 employees (432 men, 158 women) who worked

at the landll between 1983 and 2018 for at least 3 months was followed

up until 31.12.2021. With an SIR of 0.71 (95% condence interval (CI):

0.48, 1.00) and SMR of 0.51 (95% CI: 0.35, 0.73), cancer incidence and

total mortality were not increased among employees. Prolonged employ-

ment at the landll was not associated with increased cancer incidence or

mortality. With increasing latency, cancer incidence in the worker cohort

decreased signicantly (p=0.0497 for trend).

Discussion: Compared to the results of the previous studies, the cancer

incidence among the employees has further decreased. One third of the

cohort was followed up for more than 30 years, so that cancers with a

longer latency period were included in the analyses.

Conclusion: e implementation of a comprehensive occupational health

management system and increased employee awareness in handling of

hazardous materials was associated with a decrease in cancer and mortal-

ity rates in the employee cohort.

Disclosure Statement: e authors declare no conict of interest.

481

Update on longitudinal health-related quality of life up to

ve years after radiotherapy in an international multicentre

cohort study in men with non-metastatic prostate cancer

Philipp Heumann1,2; Juan Camilo Rosas Romero1; Miguel

E. Aguado-Barrera3; David Azria4; Erik Briers5; Ananya Choudhury6;

Dirk R. de Ruysscher7; Sara Gutiérrez-Enríquez8; Rudolf Kaaks1;

Maarten Lambrecht9; Carlos López-Pleguezuelos3; Tiziana Rancati10;

Tim Rattay11; Barry S. Rosenstein12; Elena Sperk13; Hilary Stobart14;

Chris Talbot11; Ana Vega15; LIV Veldeman16; Tim Ward14; Adam Webb11;

Catharine ML West6; Jenny Chang-Claude1,17; Petra Seibold1

1Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Deutschland

2Universität Heidelberg, Medizinische Fakultät, Heidelberg, Deutschland

3Instituto de Investigación Sanitaria De Santiago de Compostela, Santiago de

Compostela, Spanien

4ICM Institut du Cancer Montpellier, Montpellier, Frankreich

5Patient Advocate, Hasselt, Belgien

6The University of Manchester, Manchester, United Kingdom

7Maastro Clinic, Maastricht, Niederlande

8Vall d’Hebron Institute of Oncology (VHIO), Vall d’Hebron Barcelona Hospital

Campus, Barcelona, Spanien

9KU Leuven, Löwen, Belgien

10Fondazione IRCCS Istituto Nazionale dei Tumori, Mailand, Italien

11University of Leicester, Leicester, United Kingdom

12Mount Sinai School of Medicine, New York, USA

13Mannheim Cancer Center, Universitätsmedizin Mannheim, Medical Faculty

Mannheim, Heidelberg University, Mannheim, Deutschland

14Patient Advocate, London, United Kingdom

15Fundacion Publica Galega Medicina Xenomica, Santiago de Compostela,

Spanien

16Ghent University Hospital, Gent, Belgien

17Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland

Background: Analyses of fatigue and global health status in a prostate

cancer (PCa) patient cohort investigating health-related quality of life

(HRQoL) were expanded to include further functional and symptom

scales.

Methods: 1,760 men with non-metastatic PCa recruited between 2014

and 2016 into the observational REQUITE study in 7 European coun-

tries and the USA before radiotherapy (RT; +/- hormonal treatment, +/-

prostatectomy) reported HRQoL at baseline before (N=1,704), at the end

(N=1,647), and annually up to 5 years aer RT (N=518) using the EORTC

QLQ-C30. Normalized mean scores for functioning/symptom scales

(0-100) were calculated, with higher values indicating higher functioning/

symptom burden.

Result: e largest deteriorations pre- vs. post-RT were observed in

diarrhoea, fatigue and role functioning with dierences of 13.7, 9.3, and

6.9 scores, respectively, which returned to baseline levels at 5-years. e

largest proportions of patients with clinically important levels (i.e. above

thresholds proposed in PMID: 31639445) were observed for diarrhoea

(38%) at the end of RT and dyspnoea (30%) 5 years post-RT. While the

proportion for diarrhoea returned to pre-RT levels (11%), consistently

≥23% of long-term survivors reported dyspnoea. Minor score dierences

(below the clinically relevant threshold of 10 scores) were found between

men <70 vs ≥70 years. Compared to European general population data

(PMID: 30576971), PCa patients reported better scores 5 years aer RT

for all scales than men in their age group.

Discussion: For most functioning and symptom scales, post-RT deterio-

ration returned to baseline levels during the 5-year follow-up.

Conclusion: Descriptive analyses of aggregated data suggested an over-

all good HRQoL, however the C30 might not comprehensively capture

unmet health needs in this cohort. To account for intra- and inter-indi-

vidual variability in HRQoL trajectories, growth mixture models adjusted

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts50

for relevant demographic, treatment and tumour-specic covariates to

identify vulnerable subgroups will be presented at the congress.

Disclosure Statement: e authors declare no conict of interest.

495

The incidence and associated factors of second primary

cancers following survival of colorectal cancer – a nationwide

analysis of 217,202 survivors

Linda Liang; Ying-Ju Tseng; Luana Fiengo Tanaka; Stefanie Klug

Chair of Epidemiology, Department of Sport and Health Science, Technical

University of Munich, Munich, Deutschland

Background: With improved survival of colorectal cancer (CRC), the risk

of developing a second primary cancer (SPC) is increasing. Additionally,

CRC is increasing in younger populations (<50 years). We determined the

incidence and potential associated factors of SPC following CRC.

Methods: CRC cases (ICD-10 C18-C20) aged ≥20 years (diagnosed in

1990-2011) from the German Centre for Cancer Registry Data (ZfKD)

were extracted. SPC was dened as any subsequent cancer diagnosed

(excluding non-melanoma skin cancer) until the end of 2013 with a

dierent histological group. Incidence was calculated as standardized

incidence ratios (SIR) and 95% condence intervals (CI) were Poisson

distributed. Cause-specic Cox regression examined associated factors of

SPC, accounting for death as a competing risk.

Result: Of 217,202 CRC cases included (median age 70 years), 18,751

SPCs occurred (8.63%). In males and females, SPC risk increased by 36%

(SIR: 1.36 [95% CI 1.34-1.38]) and 46% (SIR: 1.46 [95% CI 1.43-1.49])

respectively. SPC incidence was almost four-fold for survivors <50 years

compared to the respective general population (SIR males: 4.51 [95% CI

4.04-5.01]; females: 4.03 [95% CI 3.62-4.48]). Risk of SPC (all ages) fol-

lowing both colon cancer (CC) and rectal cancer (RC) was increased in

the digestive, urinary, female and male reproductive organs. Smaller pri-

mary tumor size and right-sided CRC were associated SPC risk factors.

Treatment of CC was not associated with SPC but the risk was lowered for

RC aer chemotherapy.

Discussion: CRC survivors, particularly younger cases, are at increased

risk of SPC. Primary tumor-related characteristics were associated risk

factors.

Conclusion: Our ndings may guide tailored screening of CRC survivors.

Indication of source:

1 Liang, LA, Tseng, Y-J, Tanaka, LF, Klug, SJ. Second primary cancer among

217702 colorectal cancer survivors: An analysis of national German cancer

registry data. International Journal of Cancer. 2023; 1–13. doi:10.1002/ijc.34638.

Disclosure Statement: e authors declare no conict of interest.

496

Risk Estimation for Second Primary Lung Cancer in German

Lung Cancer Survivors Based on Tumor Histology

Marian Eberl1; Klaus Kraywinkel2; Luana Fiengo Tanaka1; Stefanie Klug1

1Chair of Epidemiology, Department of Sport and Health Science, Technical

University of Munich, Munich, Deutschland

2Robert Koch Institut, German Center for Cancer Registry Data, Berlin,

Deutschland

Background: e published standardized incidence ratios (SIR) for lung

cancer (LC) aer lung cancer are unexpectedly low in Germany (1). ese

might be underestimated in registries that use IARC multiple primary

due to the histology-dependent documentation of secondary primary

cancer (SPC) with the same location as the rst cancer. is study aims to

improve the estimation of SIR for second primary lung cancer (SPLC) in

German LC survivors using histology-specic reference rates.

Methods: We use data of German LC survivors from 11 regional can-

cer registries diagnosed between 2002 and 2013. We present updated risk

estimates for SPLC using a novel method to calculate histological sub-

type-specic SIRhist and compare results to the traditional SIR.

Result: In total, 154 women and 388 men (0.4% of patients) of the

included 135,572 LC survivors have developed an SPLC. e adjusted rel-

ative risk of developing an SPLC was 2.98 (95% CI: 2.53–3.49) for females

and 1.15 (95% CI: 1.03–1.27) for males. e histological subtypes of index

LC with the highest SIR was squamous cell carcinoma (SIRhist = 5.17, 95%

CI: 3.94–6.67) in women and small-cell carcinoma (SIRhist = 1.36, 95% CI:

0.99–1.81) in men.

Discussion: Our newly developed method of histology-specic SIR can

reduce bias when estimating the risk of same-site SPC. e adjusted esti-

mates for the risk of SPLC in LC survivors are substantially higher than

previously published unadjusted SIR.

Conclusion: Our ndings impact the international comparison of SPC

rates using cancer registry data, particularly regarding estimations follow-

ing IARC versus SEER rules.

Indication of source:

1 Eberl M, Tanaka LF, Kraywinkel K, Klug SJ. Incidence of Smoking-Related

Second Primary Cancers Aer Lung Cancer in Germany: An Analysis of

Nationwide Cancer Registry Data. J orac Oncol. 2022;17(3):388–98.

Disclosure Statement: e authors declare no conict of interest.

503

Semi-quantitative assessment of environmental

tobaccosmoke exposure and its association with the

development oforal squamous cell carcinoma: A pilot study

Susanne Wolfer1; Henning Schliephake1; Thomas Asendorf2;

PhilippKaumann1

1Universitätsmedizin Göttingen Abteilung für Mund-, Kiefer- und

Gesichtschirurgie, Göttingen, Deutschland

2Institut für Medizinische Statistik - UMG, Göttingen, Deutschland

Purpose: Environmental tobacco smoke (ETS) is considered as a health

risk factor and has been proven to be associated with the occurrence of

various diseases (1-3). An individual assessment of exposure to ETS was

not done so far. is study intends to numerically record and evaluate the

exposure to lifelong ETS using the oral squamous cell carcinoma (OSCC)

as a smoke-related carcinoma.

Methods: Using a standardized questionnaire, 165 cases and 167 controls

were asked about their risk behaviors, including ETS exposure. An ETS-

score was developed to semi-quantitatively record the exposure to ETS.

Statistical descriptive and explorative analyses were performed.

Result: Cases had an increased ETS exposure compared to the controls

(ETS-score: 36.69 vs 13.92; p<0.0001). In the cases, there was a clear

increase in the ETS-score with increasing risk behavior (p<0.0067).

Signicant dierences in ETS-score were found for dierent tumor loca-

tions (p=0.0012) and histopathological gradings (p=0.0399). ETS expo-

sure was conrmed as an independent risk factor for developing OSCC

(p<0.0001).

Discussion: A recent review conrms that passive smoking inuences the

development of OSCC (4). However, there was no individual recording of

ETS exposure. We even found an increased risk by 1% with an increasing

ETS-score by 1 point. is has never been reported in the literature and

shows the good functionality of the score.

Conclusion: e presented ETS-score has shown to be a sensitive meas-

ure for assessment of ETS exposure. Further studies are needed for con-

rmation and validation of the usefulness of the ETS-score as a numerical

measurement of ETS exposure. is ETS-score could be used as an easy-

to-use instrument in everyday clinical practice for the detection of other

diseases possibly associated with ETS.

References:

1. Ni X et al. Int J Environ Res Public Health. 2018 Jun 27;15(7):1348.

2. Luo J et al. BMJ. 2011 Mar 1;342:d1016.

3. Wang Y et al. PLoS One. 2013 Jul 26;8(7):e69915.

4. Mariano LC et al. Tob Control. 2022 Sep;31(5):597–607.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 51

644

Cancer-related fatigue at the end of radiotherapy as a

prognostic factor for 10-year overall survival in women

with breast cancer

Philipp Heumann1,2; Axel Benner1; Sabine Behrens1;

Jenny Chang-Claude1,3; Petra Seibold1

1Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Deutschland

2Universität Heidelberg, Medizinische Fakultät, Heidelberg, Deutschland

3Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland

Background: e prognostic value of severe cancer-related fatigue (CRF)

at the end of radiotherapy (RT) for 10-year overall survival was inves-

tigated in a cohort of women with non-metastatic breast cancer (BCa).

Methods: Data from the prospective multicentre ISE study were ana-

lysed, which enrolled women with non-metastatic BCa aer breast-con-

serving surgery and before RT without chemotherapy between 1998 and

2001 in the Rhine-Neckar-Karlsruhe region in Germany. A vital status

follow-up was conducted in 2019 (median follow-up: 19 years). Health-

related quality of life was collected at the end of RT using the EORTC

QLQ-C30 and normalised to scores from 0-100. Severe CRF 2 to 6 weeks

aer RT was classied as ≥39 scores using the threshold of clinical impor-

tance (PMID31639445). Overall survival was dened as the time from

CRF assessment to death, with events censored aer 10 years of follow-up.

Hazard ratios (HR) and 95% condence intervals [95% CI] were derived

from a Cox regression model adjusted for CRF, age, BMI at surgery, T stage,

lymph node involvement, grading and receptor status.

Result: Of 437 patients with fatigue assessments, 164 (38%) reported clin-

ically important severe CRF. During the 10-year follow-up, 23 patients

without (46%) and 27 patients with CRF (54%) died. CRF was modelled

with a step function at 5 years of follow-up due to non-proportional haz-

ards. T stage (HR: 3.02 [1.69, 5.38]), nodal involvement (HR: 2.56, [1.41,

4.65]) and age (HR: 1.05 [1.02, 1.09]) were signicantly associated with

overall survival. For CRF, a statistically signicant eect was observed for

≥5 years of follow-up (HR: 2.44 [1.12, 5.32]), but not for <5 years (HR:

1.26 [0.56, 2.84]).

Discussion: Further analyses will be presented at the conference, extend-

ing the follow-up period and exploring whether other patient-reported

outcomes such as global health status are prognostic for survival.

Conclusion: Beyond established prognostic factors of tumour size, nodal

involvement and age, severe CRF aer RT was associated with lower over-

all survival aer ≥5 years of follow-up.

Disclosure Statement: e authors declare no conict of interest.

651

Signicant Underestimation of Preventive Eects in Colorectal

Cancer Screening Trial

Thomas Heißer; Michael Homeister; Hermann Brenner

Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Deutschland

Background: Follow-up results of the randomized NordICC trial revealed

a presumably smaller than expected protective eect of screening colonos-

copy to prevent colorectal cancer (CRC). However, measured incidence

reduction is biased due to inclusion of preclinical cases already present at

recruitment, which can no longer be prevented. We aimed to quantify the

true impact of screening colonoscopy in NordICC.

Methods: Using a thoroughly validated modelling approach, we repli-

cated NordICC by matching simulated subjects with reported numbers,

and derived expected incidence aer excluding cases that manifested

during follow-up but were already prevalent at baseline. Key outcomes

were the adjusted (i.e., unbiased, excluding prevalent cancers at baseline)

and observed (i.e., as reported) risk ratios (IRR) for screening versus no

screening.

Result: Driven by the inclusion of a large proportion of prevalent can-

cers, observed cumulative incidence was higher in the screening versus

control group in the initial years aer randomization. With increasing

length of follow-up, observed cumulative incidence was lower in those

screened. However, this incidence reduction was still much lower than

adjusted incidence reduction due to inclusion of prevalent cases in calcu-

lation of observed cumulative incidence. In intention-to-screen analysis

observed/adjusted risk reductions aer 6, 8 and 10 years of follow-up were

5%/32%, 13%/31%, and 17/30%, respectively. In per-protocol analysis,

respective observed/adjusted risk reductions were 12%/75%, 29%/73%,

and 39%/70%.

Conclusion: e preventive eect of screening colonoscopy is likely much

stronger than reected in reported RRs. Published ndings of NordICC

signicantly underestimate the true preventive eective of screening colo-

noscopy even aer 10 years of follow-up.

Disclosure Statement: e authors declare no conict of interest.

656

Projected patient numbers of (HER2+) metastatic gastric

cancer (mGC) in the German statutory health insurance (SHI):

A claims data analysis

Jaime Luna1; Jürgen Hess2; Magnus Lutz2; Bernhard Mörtl2; Nils Picker3;

Thomas Wilke4; Yan Xiong5; Thorsten Götze6

1Cytel, Berlin, Deutschland

2Daiichi-Sankyo Deutschland, München, Deutschland

3Cytel, Wismar, Deutschland

4IPAM, University of Wismar, Wismar, Deutschland

5Daiichi-Sankyo Inc, Basking Ridge, USA

6Krankenhaus Nordwest, Frankfurt, Deutschland

Background: Gastric cancer is one leading cause of cancer-related mor-

tality in Germany. Innovative therapies recently changed the treatment

landscape in the metastatic setting. is study aimed to estimate the

number of (HER2+) mGC patients (pts) per line of treatment (LOT) in

German SHI to support registry information with real-world data.

Methods: A retrospective analysis was conducted using anonymized

German claims data (AOK PLUS; ~3.5M insured individuals) estimating

pt numbers from 2011 to 2020. mGC pts were identied via ICD-code;

HER2+ mGC pts by a treatment proxy (trastuzumab). e age and sex-

adjusted SHI projection was performed per calendar year and stratied

per LOTs.

Result: e study cohort consisted of 2.629 mGC pts treated in 1LOT

(mean age 68.3; male 66.3%). Of those pts, 38.2% switched to 2LOT

(n=861), and 10.2% reached 3LOT (n=268). e HER2+ cohort consisted

of 214 mGC pts (mean age 67.5 years; male: 74.3%), 54.7% switched to

2LOT (n=117), and 27.1% reached 3LOT (n=58). e mean number of

mGC cases projected on SHI population over the last 5 years 2016-2020

starting 1LOT annually was 7.119 (2016: 5.789, 2017: 7.122, 2018: 7.250,

2019: 7.412, 2020: 8.024); 2.585 for 2LOT (2.409, 2.603, 2.349, 2.662,

2.901) and 920 for 3LOT (655, 1.064, 839, 1.005, 1.035). e mean num-

ber of estimated HER2+ cases in the SHI starting 1LOT was 576 (565, 441,

687, 673, 516); 362 for 2LOT (193, 298, 390, 500, 429) and 190 for 3LOT

(160, 236, 138, 300, 117).

Discussion: Epidemiological registries rarely include data on clinical var-

iables, diagnostic testing, or shares in LOT. German SHI data analyses can

help to close this gap. In this study, the projected mGC numbers in 1LOT

are slightly higher than expected. For mGC pts in ≥2LOT or the HER2+

cohort, the projections are consistent with registry and literature based

estimations.

Conclusion: is study provides valuable insights into mGC numbers.

Further improvement of available data in Germany, including data-link-

age of SHI and registry data, is needed to provide comprehensive informa-

tion on both epidemiological and clinical research questions.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts52

829

The Rising Incidence of Early-Onset Colorectal Cancer

Stefanie Klug1; Nina Buttmann-Schweiger2; Luana Fiengo Tanaka3;

Vera Popova4; Sieglinde Hechenbichler Figueroa5

1TU München, Fakultät für Sport- und Gesundheitswissenschaften, München,

Deutschland

2Robert Koch Institut, Zentrum für Krebsregisterdaten, Berlin, Deutschland

3TU München, Fakultät für Sport- und Gesundheitswissenschaften, München

4München, Deutschland

5TU München, München, Deutschland

Background: e incidence of colorectal cancer diagnosed before the age

of 50 (early onset, EO-CRC) is increasing in some high-income countries.

In the present study, this trend was analyzed for Germany (1).

Methods: e Center for Cancer Registry Data (ZfKD) provided data on

the incidence of colorectal cancer (ICD-10 C18-C20) from German epi-

demiological state cancer registries with sucient coverage during 1999-

2018. Cases identied only by death certicates were excluded. Mortality

data were taken from ocial cause-of-death statistics. Temporal trends

were presented as average annual percentage change (AAPC) with 95%

condence intervals. Incidence was reported stratied by sex and site of

occurence (proximal colon, distal colon, and rectum), 10-year age group

(20-29, 30-39, and 40-49), and tumor size (T).

Results: 5.1% (9 529 cases) of all colorectal cancer cases in the selected

German regions were diagnosed before the age of 50 years. e incidence

of EO-CRC increased annually by 1.16% (95-% condence interval: 0.51;

1.81) in men and by 1.32% [0.80; 1.84] in women. e incidence of cancer

in the proximal colon increased in both sexes (men AAPC: 3.26% [2.00;

4.53]; women AAPC: 2.99% [2.17; 3.83]), whereas the incidence of cancer

in the distal colon remained stable.

Discussion: Increasing incidence of EO-CRC has been identied in at

least 19 high-income countries, with the greatest yearly changes seen in

New Zealand, the UK, Canada, and Australia. e overall annual increase

found in Germany by this study is less pronounced, but similar to the

gures re-ported for Sweden, Denmark, and Slovenia.

Conclusion: e incidence of EO CRC is increasing in Germany. e rea-

sons are probably multifactorial and reect the changing prevalence of

risk and protective factors one is exposed to in early life.

Indication of source:

1 Dtsch Arztebl Int 2023; 120: 59–64. DOI: 10.3238/arztebl.m2022.0368.

Disclosure Statement: e authors declare no conict of interest.

853

Occurrence of cancer in people with intellectual disabilities in

Germany in 2019

Andreas Berger1; Marie-Luise Rosenbusch2; Ramona Hering2;

MandySchulz2; Christoph Kowalski3; Nora Tabea Sibert3;

Thomas Seuerlein4; Tanja Sappok5

1Evangelisches Krankenhaus Königin Elisabeth Herzberge gGmbH, Klinik für

Innere Medizin II, Berlin, Deutschland

2Zentralinstitut für die kassenärztliche Versorgung in der Bundesrepublik

Deutschland, Berlin, Deutschland

3Deutsche Krebsgesellschaft e. V., Versorgungsforschung, Berlin, Deutschland

4Universitätsklinikum Ulm, Klinik für Innere Medizin I, Ulm, Deutschland

5Universitätsklinikum OWL der Universität Bielefeld, Krankenhaus Mara gGmbH

– Universitätsklinik für Inklusive Medizin, Bielefeld, Deutschland

Background: Approximately 0.5-1 million people with an intellectual

disability (ID) life in Germany with reduced life expectancy, namely due

to malignancy (20%). Data on cancer prevalence of people with ID in

Germany are not yet available.

Methods: Relative risk for various cancer diagnoses (ICD-10: C00-C97;

M1Q, secured) in people with/without ID (age/sex/district-matched) in

nationwide outpatient billing data of all statutory health insurance patients

(0-107 years) in 2019 were analyzed. Ethics vote of the ethics committee of

the Berlin Medical Association is available (Eth-11/23).

Result: ere were data of 438.028 people with ID (F70-79, M2Q inclu-

sion diagnoses) and 65.762.146 people without ID, in 2019. Aer match-

ing for age, sex, and district code, data from 437.802 people with ID and

4.378.020 without ID (0-95 years, male/female) were available. Data from

16.133 people with ID and cancer and 201.369 with cancer but without

ID were analyzed. Univariate Odds Ratios (OR) were calculated. Across

all cancers, people with ID showed lower risks for a cancer diagnosis

(OR 0.83; 95% Condence Interval [95% CI] 0.82-0.84). Certan cancers

occurred more oen, such as malignant neoplasms of the brain (C71; OR

2.80; 95% CI 2.58-3.03), spinal cord, cranial nerves and other parts of the

central nervous system (C72 ; OR 2.45; 95% CI 1.76-3.34), testicles (C62;

OR 1.80; 95% CI 1.68-1.93), corpus uteri (C54; OR 2.02; 95% CI 1.86-

2.19), and leukemia (C95; OR 1.86; 95% CI 1.67-2.06). However, other

entities such as malignant melanoma type (C43; OR 0.55; 95% CI 0.51-

0.59) or GI tumor type (C15-26; OR 0.90; 95% CI 0.86-0.94) occurred

less oen.

Discussion: People with an ID showed a decreased risk for being diag-

nosed with cancer, may be due to diculties in accessing the health sys-

tem and lower cancer screening rates and hereby lead to lower prevalence

rates in this nationwide sample.

Conclusion: Medical services and screening programs for people with ID

need to be built-up, adapted and expanded to meet the needs of people

with ID.

Disclosure Statement: e authors declare no conict of interest.

Epigenetic and Metabolomic Targets

901

HDAC inhibitors activate lipid peroxidation and ferroptosis in

gastric cancer

Robert Georg Jenke1,2,3; Denys Oliinyk3,4; Justus Körfer1,5; Linda

Schäker-Hübner6; Ingo Bechmann5; Finn K. Hansen6; Florian Lordick1,3;

Florian Meier-Rosar3,4; Achim Aigner2; Thomas Büch2

1University Cancer Center Leipzig (UCCL), University Hospital Leipzig, Leipzig,

Deutschland

2Leipzig University, Medical Faculty, Rudolf-Boehm-Institute for Pharmacology

and Toxicology, Clinical Pharmacology, Leipzig, Deutschland

3Comprehensive Cancer Center Central Germany (CCCG), Leipzig and Jena,

Deutschland

4Jena University Hospital, Functional Proteomics, Research Center Lobeda, Jena,

Deutschland

5University Hospital Leipzig, Institute for Anatomy, Leipzig, Deutschland

6University of Bonn, Pharmaceutical Institute, Department of Pharmaceutical

and Cell Biological Chemistry, Bonn, Deutschland

Background: Gastric cancer remains one of the deadliest neoplasms

worldwide, with a high need for new therapeutic options. Ecacies of tar-

geted therapies are oen limited owing to the inter- and intratumoral het-

erogeneity of gastric cancer. us, drugs with broader impact on multiple

pathways might provide a substantial benet over the inhibition of only

a single oncogene. Preclinical studies have identied histone deacetylases

(HDAC) and their respective isoforms as potential therapeutic targets in

gastric cancer. Since clinical ecacies have been moderate, the mecha-

nism(s) of action of HDAC inhibitors (HDACi) need further investigation.

Methods: In a panel of gastric cancer cell lines tumor cell inhibitory eects

of dierent HDACi were studied. Lipid peroxidation levels were measured

using ow cytometry. Proteome analysis was performed for the in-depth

characterization of molecular alterations upon HDAC inhibition. HDACi

eects on important ferroptosis genes were validated on the mRNA and

protein level.

Result: Upon HDACi treatment, lipid peroxidation levels were increased

in all tested cell lines. Proteome analysis revealed signicant and concord-

ant alterations in the expression of proteins involved in the ferroptosis

pathway. Key enzymes like ACSL4, POR or SLC7A11 showed distinct

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 53

alterations in their expression patterns, providing an explanation for the

increased lipid peroxidation. Alterations of mRNA expression of POR and

SLC7A11 levels upon treatment were also examined in primary human

gastric cancer tissue cultures.

Discussion & Conclusion: Ferroptosis is involved in the antitumor eects

of HDAC inhibitors in gastric cancer while this occurs via downregulat-

ing anti-ferroptotic and upregulating pro-ferroptotic enyzmes. We iden-

tify the induction of ferroptosis as a new mechanism of action of class-I

HDACi in gastric cancer, independent of the genetic background of the

cell lines. We therefore introduce lipid peroxidation as a new general eect

of HDACi induced anti-tumor eects.

Disclosure Statement: e authors declare no conict of interest.

Gastrointestinal Cancer: Colorectal

Comprehensive proling of broblasts reveals the origin

andactivation of disease-promoting subtypes in human

colorectal cancer

Richard Demmler1; Charles G. Anchang2; Yong S. Yong1; Simon Rauber3;

Benjamin Schmid4; Vera S. Schellerer5; Elisabeth Naschberger1;

AndreasRamming3; Michael Stürzl1

1Universitätsklinikum Erlangen, Division of Molecular and Experimental Surgery,

Erlangen, Deutschland

2Vindex GmbH, Potsdam, Deutschland

3Universitätsklinikum Erlangen, Department of Medicin 3, Erlangen

4Optical Image Centre Erlangen, Erlangen, Deutschland

5Universitätsklinikum Greifswald, Department of Visceral Surgery, Pediatric

Surgery, Greifswald, Deutschland

Background: Cancer-associated broblasts (CAFs) are a major player in

the architecture of the tumor microenvironment (TME) and the progres-

sion of cancer. CAFs are phenotypically heterogeneous. Several CAF sub-

types were proposed, including inammatory CAFs and myobroblastic

CAFs, but a precise characterization of their stability and function in can-

cer remains unclear1. Buechler et al. proposed a PI16-expressing subtype

as the unspecialized normal broblast (NAF) state from which dierent

activated phenotypes can arise2. e goal of this study is to give a more

precise look into the dierent subtypes of CAFs and their respective func-

tions in colorectal cancer (CRC).

Methods: Bulk/Single-cell RNA Sequencing, Western Blot, qPCR, IHC, ICC

Result: Bulk RNA Sequencing of isolated and cultured broblasts of

human colorectal cancer (n=6) and healthy colon (n=3) revealed a sta-

ble NAF and CAF signature which is preserved in vitro. Findings were

conrmed by Western Blot, qPCR and Immunohistochemical stain-

ings. Four major subtypes could be identied in normal colon and CRC

using a public single-cell RNA Seq dataset of CRC3. NAF activation into

Myobroblasts was achieved via TNF-α and TGF-β stimulation and went

along with the loss of the NAF signature.

Discussion: Here isolated primary CAFs and corresponding NAFs from

human CRC were established to study their role in the disease. Stable sub-

types of broblasts were preserved in cell culture and portrayed based on

their transcriptome and function. e existence of the PI-16 subtype was

conrmed in cultured NAFs and further characterized. e activation of

this subtype into cancer-promoting subtypes was recreated in vitro.

Conclusion: We determined major dierences between cultured CAFs

and NAFs of human CRC and identied disease-relevant subpopulations

originating from an unspecialized normal broblast population.

References:

1. Öhlund D. et al., J Exp Med 2017.

2. Buechler M. B. et al., Nature 2021.

3. Lee, H. O. et al., Nat Genet 2020.

Disclosure Statement: e authors declare the following: C.G.Anchang is aliated

with VINDEX GmbH.

The patient-derived cancer spheroid model predicts response

to chemotherapy in curatively resected patients with high-risk

stage II and stage III colon cancer

Barbara Mayer1; Isabella Held1; Kathrin Halfter2; Jens Werner1

1Department of General, Visceral and Transplantation Surgery, LMU University

Hospital, LMU Munich, München, Deutschland

2The Institute for Medical Information Processing, Biometry and Epidemiology,

LMU Munich, München, Deutschland

Background: e prospective SpheroPCT cohort study was conducted

to evaluate the chemopredictivity of the patient-derived cancer spheroid

model (PDCS) in locally advanced CRC.

Methods: Tumor spheroids were prepared from 48 colorectal can-

cer patients (R0M0) with UICC-II high-risk and UICC-III tumors for

48 h and treated with guideline-recommended chemotherapy for 72 h.

Treatment ecacy was measured by ATP luminescence assay and multi-

variately correlated with 5-year disease-free survival (DFS).

Result: CRC patients treated according to the most eective test results

did not experience tumor recurrence within the 5-year follow-up (32 of

36 patients, 88.9%). In contrast, tumor recurrence occurred in patients

who did not receive the best therapy suggested by the PDCS model (7

of 12 patients, 58.3%, p<0.001). Drug testing in the PDCS model proved

to be an independent predictor of drug response (HR 0.191, 95% CI

0.045-0.801, p=0.024). Test specicity was calculated to be 86.5% and test

sensitivity was calculated to be 74.6%. Consistent with guideline recom-

mendations, drug testing in the PDCS model showed no improvement in

treatment ecacy with the addition of irinotecan to 5-FU or cetuximab

to 5-FU in combination with oxaliplatin (FO). In six of the 11 relapsed

patients (54.5%), the test detected a more eective treatment option than

the given one. Two CRC patients were classied as chemoresistant. For

nine of 13 patients (69.2%) who required reduction of standard chemo-

therapy with FO due to severe side eects, the PDCS model identied an

equivalent or more eective treatment option.

Discussion: e data suggest that preclinical drug testing in the predictive

PDCS model should be translated to clinical practice. is strategy could pro-

vide more eective and less toxic therapeutic options for individual cancer

patients, resulting in prolonged survival and improved quality of life.

Conclusion: e patient-derived cancer spheroid model supports deci-

sion making in personalized cancer therapy.

Disclosure Statement: e authors declare no conict of interest.

230

Inuence of laparoscopic versus open surgery on humoral

immunity in patients with colorectal cancer: a systematic

review and meta-analysis

Annika Bohne1; Elena Grundler1; Helge Knüttel1; Vinzenz Völkel3;

AloisFürst4

1Universität Regensburg, Regensburg, Deutschland

2Tumorzentrum Regensburg, Zentrum für Qualitätssicherung und

Versorgungsforschung der Universität Regensburg, Regensburg, Deutschland

3Caritas-Krankenhaus St. Josef, Klinik für Allgemein-, Viszeral-, Thoraxchirurgie

und Adipositasmedizin, Regensburg, Deutschland

Background: Laparoscopic surgery (LS) and open surgery (OS) are the

main surgical treatment options for colorectal cancer (CRC), which might

dier in their impact on host immunity so indispensable for anti-infectious

and antitumor defence.

Methods: Included in this systematic review and meta-analysis were

randomized controlled trials (RCTs) measuring parameters of humoral

immunity up to eight days aer LS compared to OS in adult patients

with CRC of any stage. MEDLINE, Embase, Web of Science (SCI-

EXPANDED), Cochrane Library, Google Scholar, ClinicalTrials.gov and

ICTRP were systematically searched. Risk of bias (RoB) was assessed

using the Cochrane RoB2 tool. Random-eects meta-analysis of mean

dierences (MD) was performed. Methods were prospectively registered

in PROSPERO (CRD42021264324).

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts54

Result: Twenty RCTs with 1,131participants were included. RoB was rated

low in ve, of some concerns in 13, and high in two studies. Quantitative

synthesis found concentrations of parameters to be signicantly lower

aer LS for IL-6 and CRP at 3-9h (CRP MD -1.67 mg/dl 95% CI [-3.25,

-0.08] p=0.04, IL-6 -86.71 pg/ml [-125.05, -48.37] p<0.00001), at post-

operative day (POD) 1 (CRP -3.68 mg/dl [-5.05, -2.32] p<0.00001, IL-6

-26.88 pg/ml [-31.27, -22.50] p<0.00001) and at POD 2 (IL-6 -11.47 pg/ml

[-16.32, -6.63] p<0.00001). IL-8, TNFα and VEGF also showed lower con-

centrations aer LS at 0-2h (IL-8), 3-9h (IL-8, TNFα) and POD 1 (IL-8,

VEGF). No meta-analysis yielded results favouring the OS group.

Discussion: e increase in postoperative concentrations of several

proinammatory parameters was signicantly less pronounced aer LS

in the analyses, especially in the early postoperative period up to POD1.

e main limitations of the included RCTs were small sample sizes and a

heterogenous choice of measuring timepoints.

Conclusion: e summarized evidence favours the laparoscopic approach

over the open approach in regard to a milder postoperative proinamma-

tory reaction, although further research is desirable.

Disclosure Statement: e authors declare no conict of interest.

253

Does the Prognosis of Colorectal Cancer Depend on the

Age of Onset?

Caroline Deutschmann; Lutz Mirow; Hagen Rudolph

Allgemein- und Viszeralchirurgie Klinikum, Chemnitz, Deutschland

Background: Colorectal cancer (CRC) is one of the most frequent tumor

entities in Germany. Less than 10% of all patients are under 50 years of

age. But several studies expect an increase in the incidence rate in this

age group.

In this paper I study its prognosis depending on the age of its onset in

patients.

Methods: I conducted a retrospective data analysis of all surgical primary

cases with colon or rectal carcinoma at Klinikum Chemnitz diagnosed

between 01/01/1995 and 12/31/2020. ese included the diagnostic codes

C18.-, C19 and C20 of ICD-10-GM-2021. Applying an age lter of “50

years or younger” and “70 years or older”, I evaluated a number of 1381

cases. e nal data for this study was compiled on 11/10/2021.

Result: Patients at 50 years or younger showed a pUICC stage III or IV

(57.6%) at the time of diagnosis. e cohort of 70 years or older was

mostly diagnosed at pUICC stage I or II (54.2%).

e share of patients in stage R2a (macroscopically discernible residual

tumor) was signicantly higher in the cohort of up to 50 years (20.5%;

≥70 years: 12.8%).

Noticeably, younger CRC patients showed more general recurrences

(≤ 50 years: 31.1%; ≥ 70 years: 13.8%), local recurrences (≤ 50 years: 15,9%;

≥ 70 years: 5.0%) and metastases (≤ 50 years: 51.5%; ≥ 70 years: 28.8%).

Up to this study‘s reference day, 47.0% of the cohort of 50 years or younger

had died. In 32.6% of these cases the tumor was the cause of death. e

cohort of 70 years or older showed 69.7% deaths, but only 29.8% were

caused by the tumor.

Discussion: Assumed causes for the progressed pUICC stage as well as

the higher recurrence and metastasis rates with younger patients are:

delayed diagnosis with unspecic symptoms appearing late, more aggres-

sive tumor biology, eects due to the birth cohort with a higher prevalence

of antibiotics medication and obesity as well as hereditary syndromes.

Conclusion: e comparatively high rate of death in patients up to

50years of age caused by a tumor indicates, that younger CRC patients

have worse prospects of survival.

Disclosure Statement: e authors declare no conict of interest.

316

An almost insurmountable immunologic barrier: A detailed

view on the interaction of hypermutated colon cancer with

autologous T cells

Sandra Schwarz1; Su Zhaoran1; Mathias Krohn1; Markus Löer2;

Andreas Schlosser3; Michael Linnebacher1

1Universitätsmedizin Rostock, Klinik und Poliklinik für Allgemein-, Viszeral-,

Thorax-, Gefäß- und Transplantationschirurgie, Molekulare Onkologie und

Immuntherapie, Rostock, Deutschland

2Universität Tübingen, Institut für Zellbiologie, Immunologie, Tübingen,

Deutschland

3Universität Würzburg, Rudolf-Virchow-Zentrum, Center for Integrative and

Translational Bioimaging, Würzburg, Deutschland

Background: e interaction of cancer and immune cells is still not com-

pletely resolved. us, we selected two colon cancer cases with patient-

derived cell lines, peripheral and tumor-inltrating T cells available for

detailed investigation.

Methods: Prior to co-culture, T cell populations were characterized

regarding immune checkpoint (PD-1, CTLA-4, LAG-3) expression and

the amount of regulatory T cells. Tumor cell line analysis covered tumor

mutational burden, antigen processing and presentation, and immune

checkpoint ligands (PD-L1, CD80/86). Aer co-culture experiments, a

degranulation assay determined tumor cell recognition.

Result: T cells co-cultured with autologous tumor cells showed only low

levels of pro-inammatory cytokines and failed at tumor recognition.

Since antigen presentation was not aected in tumor cells, we assumed

active immunosuppressive tumor cell mechanisms. Yet, the treatment

of co-cultures with immune checkpoint inhibitors (ICI) did not boost

anti-tumor immune responses. Only pre-stimulation of T cells with

tumor-specic peptides signicantly increased tumor cell recognition.

Above all, this eect was higher in peripheral than in tumor-inltrating

T cells. Further characterization of the tumor cells revealed expression

of granzyme B and proteinase inhibitor 9 (PI-9), granzyme B’s specic

inhibitor. However, in a nal cytotoxicity assay, tumor cell elimination was

signicantly higher in peptide-stimulated than control T cells and neither

ICI nor PI-9 inhibitor further improved the outcome signicantly.

Discussion: ese results prove the complexity of immune evasion and

suppression mechanisms active in tumor cells. ey further underline

the importance of more personalized approaches in future immunothera-

pies and they also demonstrate the superiority of tumor-naïve peripheral

blood T cells compared to highly exhausted tumor-inltrating T cells.

Conclusion: Tumor cells use a complex network of immunosuppressive

strategies and multimodal immunotherapeutic approaches are needed to

overcome these barriers.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 55

388

COLUMBUS 7-Year Update: A Randomized, Open-Label,

Phase 3 Trial of Encorafenib (ENC) + Binimetinib (BIN) vs

Vemurafenib (VEM) or ENC in Patients (Pts) With

BRAFV600-Mutant Melanoma

Dirk Schadendorf1; Reinhard Dummer2; Keith T. Flaherty3;

CarolineRobert4; Ana Arance5; Jan Willem B. de Groot6; Claus Garbe7;

Helen J. Gogas8; Ralf Gutzmer9; Ivana Krajsová10; Gabriella Liszkay11;

Carmen Loquai12; Mario Mandalà13; Naoya Yamazaki14; Carolin Guenzel15;

Anna Polli16; Mahgull Mahgull17; Alessandra DI Pietro18; Paolo A. Ascierto19

1University Hospital Essen, West German Cancer Center and German Cancer

Consortium, Partner Site Essen, Essen, Deutschland

2Universitätsspital Zürich, Dermatologische Klinik, Zürich, Schweiz

3Massachusetts General Hospital, Harvard Medical School, Boston, USA

4Gustave Roussy and Paris-Saclay University, Villejuif, Frankreich

5Hospital Clinic of Barcelona and IDIBAPS, Barcelona, Spanien

6Isala Oncology Center, Zwolle, Niederlande

7University Hospital Tubingen, Tübingen, Deutschland

8National and Kapodistrian University of Athens, Athens, Griechenland

9Hannover Medical School and Ruhr-University Bochum, Minden, Deutschland

10University Hospital Prague, Prag, Tschechische Republik

11National Institute of Oncology, Budapest, Ungarn

12University Medical Center of the Johannes Gutenberg University Mainz, Mainz,

Deutschland

13University of Perugia, Perugia, Italien

14National Cancer Center Hospital, Tokio, Japan

15Pzer, New York City, USA

16Pzer, Mailand, Italien

17Pzer, Sandwich, United Kingdom

18Divisione di Oncologia Medica del Melanoma, Sarcoma e Tumori Rari, IEO

Istituto Europeo di Oncologia, Mailand, Italien

19Istituto Nazionale Tumori IRCCS Fondazione Pascale, Melanoma Unit, Cancer

Immunotherapy and Innovative Therapies, Neapel, Italien

Background: In the randomized, 2-part, multicenter, open-label, phase

3 COLUMBUS study, ENC + BIN (approved in the US, EU, and other

countries) and ENC mono improved PFS and OS rates vs VEM in patients

with BRAFV600-mutant metastatic melanoma. Here we report data from

the 7-year analysis of COLUMBUS part 1.

Methods: Pts with advanced or metastatic BRAFV600-mutant melanoma

were randomized 1:1:1 to ENC 450 mg QD + BIN 45 mg BID, VEM 960 mg

BID, or ENC 300 mg QD. Pts were treatment (tx)-naive or had progression

aer 1st-line immunotherapy (IO). No prior BRAF/MEKi was allowed.

Randomization was stratied by cancer stage (IIIB + IIIC + IVM1a +

IVM1b vs IVM1c), ECOG PS (0 vs 1), and prior 1st-line IO (yes vs no).

Result: 577 pts were randomized 1:1:1 to ENC + BIN, VEM, or ENC

mono. Updated analyses were conducted aer >93 mo of minimum fol-

low-up (cuto: Jan 13, 2023). e 7 year PFS and OS rates (95% CI) were

21.2% (14.7, 28.4) and 27.4% (21.2, 33.9) in the ENC + BIN arm and 6.4%

(2.1, 14.0) and 18.2% (12.8, 24.3) in the VEM arm, respectively. TEAEs

(≥30% with ENC + BIN) were nausea, diarrhea, vomiting, arthralgia, and

fatigue. Grade 3/4 TEAEs (≥5% with ENC + BIN) were γ-glutamyltrans-

ferase increased, blood CPK increased, hypertension, ALT increased, and

anemia. Across arms, 16% to 20% of pts discontinued tx due to AEs. Aer

tx discontinuation, 15% of pts from the ENC + BIN arm, 42% from the

VEM arm, and 28% from the ENC mono arm received BRAF/MEKi tx;

42% from the ENC + BIN arm, 49% from the VEM arm, and 43% from

the ENC mono arm received checkpoint inhibitors.

Discussion: e combination ENC + BIN showed a cnsiderably higher

PFS rate and a trend towards higher OS rate than VEM.

Conclusion: With a median duration of follow-up of 100 mo, the 7-year

analysis from COLUMBUS part 1 conrms the long-term, sustained e-

cacy and known safety prole of ENC + BIN, with no new safety signals

emerging, in pts with BRAFV600-mutant metastatic melanoma.

Clinical Trial identication: NCT01909453

Previously presented at ESMO 2023, FPN (Final Publication Number): 1113P, Dirk

Schadendorf et al. - Reused with permission

Disclosure Statement: e authors declare no conict of interest.

417

Transanal total mesorectal excision: short and long-term

results of four certied colorectal cancer centers in Germany

Elena Grundler1; Michael Gerken2; Sabine Schatz3; Luca Dittrich4;

MatthiasBiebl4; Andreas Rink5; Vinzenz Völkel2; Alois Fürst3

1Universität Regensburg, Regensburg, Deutschland

2Universität Regensburg, Tumor Center Regensburg - Centre for Quality

Management and Health Services Research, University of Regensburg,

Regensburg, Deutschland

3Caritas-Krankenhaus St. Josef, Regensburg, Deutschland

4Charité Universitätsmedizin Berlin, Klinik für Allgemein- und Viszeralchirurgie,

Hindenburgdamm 30, Berlin, Deutschland

5Universitätsklinikum Essen (AöR) Klinik für Allgemein-, Viszeral- und

Transplantationschirurgie, Essen, Deutschland

Background: Transanal total mesorectal excision (TaTME) is consid-

ered a promising innovation in the treatment of low rectal cancer (1,2).

However, in some countries there exist concerns about oncologic safety, as

TaTME was not associated with benecial results in some studies (3). is

study aims to determine the long term oncologic outcome aer TaTME

surgery in Germany.

Methods: Data from patients who had undergone elective TaTME sur-

gery in four certied colorectal cancer centers in Germany between 2014

and 2021 were analyzed. e primary endpoint was the 3-year local recur-

rence rate and local recurrence free survival (LRFS). Secondary outcomes

included overall survival (OAS), operation time, completeness of local

tumor resection, lymph node resection, and postoperative complications.

Result: A total of 378 patients were analyzed. e majority was male

(n=272, 71.9%) and the mean age was 61.6 years. e mean operating time

was 264 minutes. Locally complete resection was achieved in 96.3% of the

cases; in 87.3% of the cases, twelve or more lymph nodes were harvested.

At a median follow up time of 2.5 years a local recurrence event occurred

in 8 of 326 patients without distant metastases (2.5%). is resulted in

a 3-year cumulative local recurrence rate of 2.2% and a 3-year LRFS of

88.1%. e 3-year overall survival rate was 88.9%.

Discussion: e surgeons of all four participating clinics completed train-

ing courses for TaTME. erefore, our results might not be transferable to

settings with inexperienced surgeons and low volume centers.

Conclusion: TaTME is suitable for overcoming the anatomical and tech-

nical challenges of surgery for low and very low rectum tumors and is

associated with favorable short and long-term outcomes. However, su-

cient skills and experience are mandatory prerequisites to safely integrate

the technique into surgical routine care.

Indication of source:

1. Lacy FB et al., BMC Cancer 2020.

2. Hol JC et al.,Tech Coloproctol 2019.

3. Larsen SG et al., Br J Surg 2019.

Disclosure Statement: e authors declare no conict of interest.

428

Defeated and yet not quite over - long-term memories

ofcancer

Vinzenz Völkel1; Brunhilde Steinger1; Michael Koller2;

MonikaKlinkhammer-Schalke1; Patricia Lindberg-Scharf1

1Tumour Centre Regensburg, Centre of Quality Management and Health

Services Research, University of Regensburg, Regensburg, Deutschland

2Centre for Clinical Studies, University Hospital Regensburg, Regensburg,

Deutschland

Background: anks to medical progress the number of long-term survi-

vors of colorectal cancer continues to increase. is study aimed to inves-

tigate the memories of colorectal cancer patients about their disease and

treatment experiences up to seven years aer their participation in a RCT

for direct improvement of quality of life (RCT DIQOL, 1).

Methods: A questionnaire asked colorectal cancer survivors about their

worst experiences as well as positive aspects related to the disease and

advice they would give to newly diagnosed patients. Patient* responses

were categorized and analyzed quantitatively.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts56

Result: Of 146 survivors who originally participated in the RCT DIQOL, 96

(66%) returned the questionnaire a mean of 78.3 months aer starting their

therapy. e majority (33%) of the worst experience statements related to

“psychological distress,” followed by “indigestion and discomfort with bowel

movements” (17%) and “cancer diagnosis” (16%). Of survivors with a history

of stoma, the majority (36%) described “the stoma” as their worst experience.

At 45%, “change in life priorities” was the most common positive category,

followed by “support from doctors/nurses” (25%). 43% of survivors consid-

ered “ghting spirit” the most important advice for coping with the disease.

Discussion: Comparable to the results of a previous study on breast cancer

survivors, “psychological distress,” “change in life priorities,” and “ghting

spirit” emerged as prominent concepts. In addition, some entity-specic

issues, such as the impact of a stoma, are of particular importance for

colorectal cancer survivors.

Conclusion: By communicating their memories, long-term survivors

actively shape the public perception of colorectal cancer and thus also inu-

ence future patients. ese ndings may serve as the basis for programs to

improve patient- and quality-of-life-centered follow-up of tumor patients.

Indication of source:

1 Klinkhammer-Schalke et al., Eur J Cancer.

Disclosure Statement: e authors declare no conict of interest.

439

Impact of laparoscopic versus open surgery on cellular

immunity in colorectal cancer patients: a systematic review

and meta-analysis

Annika Bohne1; Elena Grundler1; Helge Knüttel2; Alois Fürst3; VinzenzVölkel4

1Universität Regensburg, Regensburg, Deutschland

2Universitätsbibliothek Regensburg, Regensburg, Deutschland

3Caritas-Krankenhaus St. Josef, Klinik für Allgemein-, Viszeral-, Thoraxchirurgie

und Adipositasmedizin, Regensburg, Deutschland

4Tumorzentrum Regensburg, Zentrum für Qualitätssicherung und

Versorgungsforschung der Universität Regensburg, Regensburg, Deutschland

Background: Laparoscopic surgery (LS) is hypothesized to result in a

milder surgical stress response, which may contribute to the observed

clinical benets aer LS. erefore, the cellular response aer laparo-

scopic (LS) and open (OS) colorectal cancer (CRC) resections was evalu-

ated in a comprehensive systematic review and meta-analysis.

Methods: MEDLINE, Embase, Web of Science (SCI-EXPANDED), the

Cochrane Library, Google Scholar, ClinicalTrials.gov, and ICTRP were

systematically searched for randomized controlled trials (RCTs) compar-

ing cellular immunity in CRC patients of any stage between LS andOS.

A narrative synthesis and random eects-weighted inverse variance

meta-analysis was performed. e RoB2 tool was used to assess the risk of

bias (RoB). e meta-analysis was prospectively registered in PROSPERO

(CRD42021264324).

Result: A total of 14 RCTs including 974 participants were assessed.

Narrative synthesis showed higher NK cell lytic activity and HLA-DR II

expression rates, higher NK cell numbers, CD3+, CD4+ and CD8+ T-cell

counts, a higher CD4+/CD8+ ratio and lower WBCs aer LS in overall

eight trials. e meta-analyses yielded signicantly higher NK cell counts

aer LS at postoperative day (POD)4 (mean dierence (MD) 30.80 cells/

µL [19.68; 41.92],p <0.00001) and POD6–8 (MD 45.08 cells/µL [35.95;

54.21],p <0.00001). RoB was low in ve, of some concerns in seven, and

high in two studies. Except for a lower WBC aer OS in one trial, no nar-

rative or quantitative analysis favoured the OS group.

Discussion: e narrative synthesis generally showed more favourable

outcomes aer LS, being supported by the signicantly higher NK cell

counts seen in the meta-analysis. Main limitations of analyses were small

sample sizes and a heterogenous set of parameters and measuring time-

points of included RCTs.

Conclusion: Although further research is required, the laparoscopic

approach is possibly associated with lower inammation and better pres-

ervation of cellular immunity compared to OS.

Disclosure Statement: e authors declare no conict of interest.

502

FRESCO-2: A global phase 3 multiregional clinical trial (MRCT)

evaluating the ecacy and safety of fruquintinib in patients

(pts) with refractory metastatic colorectal cancer (mCRC)

Dirk Arnold1; Arvind Dasari2; Sara Lonardi3; Rocio Garcia-Carbonero4;

Maria Elena Elez Fernandez5; Takayuki Yoshino6; Alberto F. Sobrero7;

James C. Yao2; Pilar García Alfonso8; Judit Kocsis9; Antonio Cubillo

Gracian10; Andrea Satore-Bianchi11; Taroh Satoh12; Violaine Randrian13;

Jiri Tomasek14; Georey Chong15; Zhao Yang16; William Shelman16;

Marek Kania16; Josep Tabernero5; Cathy Eng17

1Asklepios Tumorzentrum Hamburg, Department of Oncology and Hematology,

AK Altona, Hamburg, Deutschland

2Department of Gastrointestinal Medical Oncology, The University of Texas MD

Anderson Cancer Center, Houston, TX, USA

3Medical Oncology Unit 1, Veneto Institute of Oncology IOV-IRCCS Padua,

Padua, Italien

4Oncology Department, Hospital Universitario 12 de Octubre, lmas 12, UCM,

Madrid, Spanien

5Vall d’Hebron Barcelona Hospital Campus, Vall d’Hebron Institute of Oncology,

Barcelona, Spanien

6Department of Gastroenterology and Gastrointestinal Oncology, National

Cancer Center Hospital East, Kashiwa, Chiba, Japan

7Department of Medical Oncology, Azienda Ospedaliera San Martino, Genoa,

Italien

8Medical Oncology, Hospital Universitario Gregorio Marañón, Madrid, Spanien

9Department of Oncoradiology, Bács-Kiskun Megyei Oktatókórház, Kecskemét,

Ungarn

10Medical Oncology, Hospital Universitario Madrid Sanchinarro Centro Integral

Oncológico Clara Campal, Madrid, Spanien

11Department of Oncology and Hemato-Oncology, Università degli Studi di

Milano, Milan, Italien

12Department of Gastroenterological Surgery, Graduate School of Medicine,

Osaka University, Suita, Japan

13Hepato-Gastroenterology Department, Poitiers University Hospital, Poitiers,

Frankreich

14Department of Complex Oncology Care, Masaryk Memorial Cancer Institute,

Brno, Tschechische Republik

15Olivia Newton John Cancer & Wellness Centre, Austin Hospital, Heidelberg,

VIC, Australien

16HUTCHMED, Florham Park, NJ, USA

17Department of Medicine, Division of Hematology and Oncology, Vanderbilt

Ingram Cancer Center, Nashville, TN, USA

Background: Eective treatment options are limited for pts with refrac-

tory mCRC. Fruquintinib (F), a highly selective, potent, oral tyrosine

kinase inhibitor of VEGFR-1, -2 and -3, was approved in China in the

3L+ mCRC setting based on results from FRESCO (NCT02314819).

FRESCO-2 (NCT04322539) evaluated F in more heavily pretreated pts

reecting current global practices.

Methods: FRESCO-2 was a randomized, double-blind, placebo

(P)-controlled, phase 3 MRCT conducted in the US, Europe, Japan, &

Australia, comparing F + best supportive care (BSC) with P + BSC. Pts

were randomized 2:1 to F 5 mg PO or P, QD, 3 wks on, 1 wk o, in 28-d

cycles. Key criteria: prior chemotherapy, anti-VEGF therapy and, if RAS

wild type, anti-EGFR therapy; if BRAFV600E mutant or MSI-H, a targeted

regimen; & prior exposure to triuridine/tipiracil and/or regorafenib.

Primary endpoint: overall survival (OS); key secondary endpoints: pro-

gression-free survival (PFS), objective response rate (ORR), disease

control rate (DCR), and safety. Final analysis was aer 480 OS events.

Results: From Aug 14, 2020–Dec 2, 2021, 691 pts were randomized (F:461

vs P:230; Europe n=495; F:329 vs P:166; Germany n=19; F:8 vs P:11; data-

cut: Jun 24, 2022). Baseline characteristics were balanced. F signicantly

improved OS overall (median 7.4 months [m] vs 4.8 m P; HR 0.66 [95%

CI 0.55–0.80]; p<0.001) and in European pts (median 7.6 m vs 4.6 m P;

HR 0.69 [95% CI 0.55–0.86]; p<0.001); and PFS overall (median 3.7 m

vs 1.8 m P; HR 0.32 [95% CI 0.27–0.39]; p<0.001) and in European pts

(median 3.7 m vs 1.9 m P; HR 0.32 [95% CI 0.26–0.40]; p<0.001). Median

follow-up was 11.3 m F vs 11.2 m P. Subsequent anticancer therapies were

29.4% F vs 34.3% P. DCR was 55.5% F vs 16.1% P and ORR was 1.5% F vs

0 P. Grade ≥3 adverse events were 62.7% F vs 50.4% P.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 57

Discussion: F had a signicant and clinically meaningful improvement

in OS vs P in pts with refractory mCRC. F was well tolerated with a

safety prole consistent with the established prole for F monotherapy.

Conclusion: FRESCO-2 results are consistent with FRESCO and should

support a new treatment option in refractory mCRC.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

542

Left hepatic lobe within an epigastric hernia associated to

liver metastasis

Conrad-Jakob Schiner1; Roland Croner2; Frank Meyer2

1Dept. of Trauma Surgery, University Hospital, Magdeburg, Deutschland

2Dept. of General, Abdominal, Vascular and Transplant Surgery; University

Hospital, Magdeburg, Deutschland

Background: Aim: An extraordinary hernia nding (le liver & intestine

within the hernia sac) is illustrated as teaching case example.

Methods: Scientic “Case report”.

Result (Case presentation): Medical history (hx): Enlarging so bulging

of the upper abdomen with no local pain (own: le hemicolectomy for

cancer [Ca] of the decending colon [pT3b pN0 {0/22} L0 V0 cM0]). Aer

2 re-laparotomies because of an anastomotic insuciency, transversos-

toma was created, which was never excided for re-establishing the GI

Passage since the patient did not agree.

Clinical nding: Male patient of middle age with previous median laparot-

omy cut (aer surgical intervention for colon Ca) with a palpable epigas-

tric fascia gap of appr. 12×20 cm (width × length - hepatic margin within

the hernia sac (Diagnosis).

Diagnostics: - In 2020, follow-up CT scan revealed hepatic tumor lesions

(secondary nding: incisional hernia w/ le lobe & intestine within the

hernia sac).

–CT-guided puncture of the hepatic tumor (Tu) lesions showed metas-

tases of the moderately dierenciated adeno-CA of the colon.

–Molecular genetics revealed KRAS-mutation, NRAS-wild type,

MMRp status.

erapy: Radiation & one cycle of FOLFOX-based chemotherapy regimen

were initiated resulting in increasing size of Tu lesions. Subsequently, ther-

apy was aborted due to a liver abscess. In 9/2020, “atypical right hemi-

hepatectomy” (resection of the segments V-VII & one third of VIII) incl.

Vicryl mesh implantation (“onlay” position) for laparotomy closure was

performed.

Outcome/follow-up investigation: e patient has been Tu-free since

X/2020 - due to his medical hx, the patient resigned stoma excision &

sucient hernia repair with a mesh.

Conclusion: e liver can be considered an unusual hernia content of an

incisional hernia in the spectrum of rare hernia ndings (e.g., Tu lesions

of peritoneal carcinomatosis within an inguinal hernia sac etc.).

Disclosure Statement: e authors declare no conict of interest.

559

NOTCH Pathway Inhibition Increases Radiosensitivity in a

Context-Dependent Manner

Hannah Flebbe; Melanie Spitzner; Carolin Schneider; Lukas Krauß;

Michael Ghadimi; Günter Schneider; Marian Grade

Universitätsmedizin Göttingen, Göttingen, Deutschland

Background: Preoperative chemoradiotherapy followed by surgical

resection represents a standard treatment for locally advanced rectal can-

cer. We recently demonstrated that activation of the NOTCH signaling

pathway increases treatment resistance (1). In the present study, our aim

was to evaluate the eect of inhibitors of the NOTCH-signaling pathway

on radiosensitivity.

Methods: Two rectal cancer cell lines with dierent modes of NOTCH

activation were treated with LY3039478, a y-secretase-inhibitor, and with

RIN1, which targets RBPJ, the key downstream transcription factor of the

NOTCH pathway. Subsequently, colony formation, cell cycle analysis and

RNA-seq was performed.

Result: e eects of NOTCH pathway inhibition were dierent between

SW837 and SW1463. While treatment with 5 µM LY3039478 resulted in

sensitization of SW837, but not SW1463, 2.5 µM RIN1 increased sensitiv-

ity to chemoradiotherapy in both cell lines. RIN1 induced a G2-arrest 24

hours aer irradiation in SW837, while there was a signicant decrease

of cells in the G1-phase aer treatment with RIN1 in SW1463. To dene

pathways regulated by the NOTCH pathway inhibitors, RNA-seq data

were analyzed. Interestingly, substantially more genes were signicantly

up- or downregulated in SW1463 compared to SW837 with only mini-

mally overlapping genes. Interestingly, however, GSEA analysis revealed

that similar pathways were deregulated in both cell lines.

Discussion and Conclusion: We demonstrated that inhibitors of the

NOTCH signaling pathway may play a role in sensitizing rectal cancer to

irradiation therapy, and should be further evaluated.

Indication of source:

1 Koerdel K, et al. NOTCH Activation via gp130/STAT3 Signaling Confers

Resistance to Chemoradiotherapy. Cancers (Basel). 2021 Jan 26;13(3):455.

doi: 10.3390/cancers13030455. PMID: 33530306; PMCID: PMC7865718.

Disclosure Statement: e authors declare no conict of interest.

585

More ecient use of colonoscopy-based colorectal cancer

screening by low-barrier, low-threshold pretesting

Thomas Heißer; Rafael Cardoso; Tobias Niedermaier;

Michael Homeister; Hermann Brenner

Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Deutschland

Background: ‘Gateopener’ colonoscopy-based screening is an innovative

concept to better target colonoscopy to those who are most likely to bene-

t from it. It combines invitations to screening colonoscopy with the oer

of pretesting with a single ‘gateopener’ fecal immunochemical test (FIT)

which is applied with a lower positivity threshold than in conventional

screening. We explored optimized use of this approach for reducing CRC

incidence and mortality.

Methods: Using COSIMO, a previously validated simulation tool, we

compared outcomes of gateopener screening to those of conventional

FIT- or colonoscopy-based screening strategies. Gateopener screen-

ing was modelled using SENTiFIT-FOB Gold (Sentinel Diagnostics) as

exemplary ‘gateopener’ FIT. We assessed various low hemoglobin cut-os

(10,8,6,4, and 3 µg/g feces).

Result: Gateopener screening at cut-os of 6, 4 or 3 µg/g outperformed

conventional screening colonoscopy in terms of CRC incidence reduc-

tion, with 16-25%, 50-57% and 66-72% more prevented cases, respectively,

aer ten years. All gateopener scenarios signicantly increased prevented

deaths, at low cut-os more than doubling the numbers achieved by con-

ventional screening colonoscopy. Compared to biennial FIT, gateopener

screening prevented 7-163% more CRC cases, with lower cut-os asso-

ciated with higher gains, and prevented approximately equal to signi-

cantly higher (12-21%) numbers of CRC deaths. Cut-os of 10 and 8 µg/g

required fewer colonoscopies per prevented case and death.

Conclusion: Gateopener screening outperforms conventional CRC

screening by oering considerably stronger reduction of CRC incidence

and mortality rates as well as considerably increased screening eective-

ness. e feasibility of the concept should be assessed by a pilot study in

real-life practice.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts58

657

Integrin β6 mediates binding of disseminated colorectal

cancer cells to endothelial cell

Chiara Van Passen1; Julia Krug2; Luisa Weiss1; René Krüger1; Mariam

Mohammed Abdou1; Philipp Busenhart3; Michael Scharl4; Elisabeth

Naschberger1; Michael Stürzl1

1Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen,

Division of Molecular and Experimental Surgery, Erlangen, Deutschland

2Universitätsklinikum Würzburg, Dermatology Department, Würzburg,

Deutschland

3Recolony AG, Zurich, Schweiz

4Universitätsspital Zürich, Klinik für Gastroenterologie und Hepatologie, Zurich,

Schweiz

Background: Aggressive disease and poor prognosis in colorectal car-

cinoma (CRC) is associated with expression of integrin β6 (ITGB6).

Furthermore, ITGB6 regulates immune evasion through the activation

of latent TGF-β. In the present study, we examined the role of integrin

β6 expression in CRC tumor cells in the adhesion to endothelial cells, a

crucial step in metastasis.

Methods: Western Blot, CRISPR/Cas9 knockout, adhesion assay and

cultivation of cells under ow.

Results: HT29 cells were identied as an ITGB6 expressing cell line

and the ITGB6 expression was deleted using CRISPR/Cas9 technology.

Control HT29 cells expressing ITGB6 showed a signicantly increased

adhesion to TNF-α or IL-1β treated HUVEC as compared to HT29 with

an ITGB6 KO under static conditions. Remarkably, the increased adhe-

sion of ITGB6 expressing cells to cytokine activated HUVEC could be

conrmed under ow conditions to mimic the blood circulation. ese

results further supported a direct role for ITGB6 in the adhesion of tumor

cells to HUVEC. Interestingly, TNF-α-induced upregulation of ITGβ6

expression in the tumor cells resulted in increased adhesion. Moreover,

adhesion of ITGB6 expressing HT29 cells could be inhibited (i) by an

ITGαvβ6 blocking antibody and (ii) an RGD peptide.

Discussion: ese results indicate that direct binding of ITGB6 con-

tributes signicantly to the adhesion of CRC tumor cells to the vascular

endothelium. e potential interaction of ITGB6 with luminal bronectin

deposits in the liver blood vessels as a mechanism of increased adhesion

of ITGB6 expressing tumour cells is under investigation.

Conclusion: Tumor cells expressing ITGB6 provoke an increased interac-

tion with endothelial cells, indicating an important, novel role of ITGB6

in the metastatic process.

Indication of source:

1 Bengs S. et al. Int J Cancer. 2019.

2 Busenhart P. et al. J Immunother Cancer. 2022.

3 Barbazán J. et al. Cancer Res 2017.

Disclosure Statement: e authors declare the following: Philipp Busenhart is the

CBO and co-founder of Recolony.

682

Tackling the complexity of cancer therapy by combining

Optim.AI™ and PD3D® models

Ulrike Pfohl1; Masturah Mohd Abdul Rashid2; Jhin Jieh Lim2; Jürgen

Loskutov1; Lena Wedeken1; Edward Kai-Hue Chow3; Hugo Saavedra2;

Christoph Reinhard1,4; Christian Regenbrecht1,4,5

1Cellphenomics GmbH, Berlin, Deutschland

2KYAN Therapeutics, Singapore, Singapore

3Cancer Science Institute of Singapore, Singapore, Singapore

4ASC Oncology GmbH, Berlin, Deutschland

5Institut für Pathologie, Universitätsklinikum Göttingen, Göttingen,

Deutschland

Background: In a previous study, we have shown that patient-derived 3D

(PD3D®) models of colorectal cancer (CRC) are dierentially sensitive to

MEK inhibitors (1). However, given the numerous genomic aberrations

and tumor heterogeneity in CRC, patients may benet from combina-

torial therapies, particularly those who have inoperable or metastatic

tumors. In the present study, we investigated the feasibility of combining

two platforms, Optim.AI™ with PD3Ds, to identify more eective cancer

therapies.

Methods: CRC PD3Ds were tested with 155 dierent combinations of

12 drugs at variant concentrations. e post-treatment cell viability was

measured and used for Optim.AI™ analysis to evaluate and compare the

best therapies. Optim.AI™ is a hybrid computational-experimental plat-

form that uses small data sets to rationally converge to optimal drug com-

binations within a dened drug search space. By mapping experimental

data points to a second-order quadratic function, Optim.AI™ can predict

cell-killing ecacy for all other possible combinations.

Result: Optim.AI™ analysis revealed dierential drug sensitivity between

CRC PD3Ds. e top-ranked drug combinations consisted of SN-38

paired with MEK-inhibitors trametinib or cobimetinib.

Discussion: Based on our preliminary data, we found dierences in the

top-ranked MEK inhibitor-based drug combinations in CRC PD3Ds with

dierent mutation proles. If these results are combined with appropriate

biomarkers, patients’ stratication based on individual sensitivity proles

and treatment outcomes will be improved.

Conclusion: is study has successfully demonstrated the feasibility and

robustness of combining Optim.AI™ and PD3Ds in identifying eective

drug combination therapies, particularly in CRC. is combined tech-

nology provides precise insights into tumor treatability and its functional

causes of treatment outcomes, leading to new treatment combinations

and accelerating the development of new cancer drugs.

Reference:

1 U. Pfohl et al., Cancers. 14, 3252 (2022).

Disclosure Statement: e authors declare the following: CRAR is shareholder at

CELLphenomics GmbH, a company oering drug screens on organoid models,

and ASC Oncology GmbH, a company involved in patient specic therapy

prediction.

698

Comparison between intraoperative peripheral and

mesenteric blood sampling with blood collection from fresh

surgical colorectal specimens

Phillip Löhr1; Bianca Grosser2; Przemyslaw Grochowski2; Andreas Rank1;

Johanna Waidhauser1; Bruno Märkl2; Dmytro Vlasenko3

1Universitätsklinikum Augsburg, 2. Medizinische Klinik, Hämatologie und

Onkologie, Augsburg, Deutschland

2Universitätsklinikum Augsburg, Institut für Pathologie und molekulare

Diagnostik, Augsburg, Deutschland

3Universitätsklinikum Augsburg, Klinik für Allgemein-, Viszeral- und

Transplantationschirurgie, Augsburg, Deutschland

Background: Recently we showed that circulating lymphocytes reect

the local immune response in colorectal cancer. Due to an assumed dilu-

tion eect during blood circulation, we developed an approach to exploit

blood in fresh surgical specimens.

Methods: Blood is aspirated from the main vein of freshly received

colorectal specimens using a standard infusion Catheter. To compare the

results with in-vivo conditions, peripheral and mesenteric blood was col-

lected during surgery. In a rst attempt, four cases were analyzed using

ow cytometry. ELISA-tests for FABP4 and the detection of circulating

tumor cells are planned for further studies.

Result: Aspirating blood was successful in 4 of 4 cases. e volumes

of collected blood varied between 2 and 3 ml. Immune cell analyses of

the three modalities (peripheral – in-vivo mesenteric – ex-vivo mesen-

teric) revealed comparable results when B cells, NK cells, and CD8 pos-

itive T cells were analyzed. However, CD4 values showed slightly higher

cell counts, as well as a higher level of early activation (expressing more

CD69) when taken from ex vivo mesenteric blood vessels. Moreover, an

increasing tendency of early, naïve and regulatory CD4 cell counts and a

decreasing trend of intermediate CD4 cell populations could be observed

in blood taken from fresh specimens.

Discussion: e preliminary results of this study prove the feasibility of

in-vivo and ex-vivo mesenteric blood sampling. Nevertheless, further

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 59

studies are needed to determine the exact role of the cellular immune

system at the boundary between local and systemic response.

Conclusion: Blood from surgical GI specimens could oer the possibility

of an easy-to-access diagnostic compartment directly at the border between

local and systemic organism, and facilitates a more precise analysis of the cel-

lular immune response in surgically treated patients with colorectal cancer.

Disclosure Statement: e authors declare no conict of interest.

711

Phase II, single-arm, open-label study of dostarlimab

monotherapy in previously untreated patients with stage II/III

dMMR/MSI-H locally advanced rectal cancer: trial in progress

Andrea Cercek1; Jean-Baptiste Bachet2; Jaume Capdevilla3; Naureen

Starling4; Eric Chen5; Maria DI Bartolomeo6; Takayuki Yoshino7; Gordana

Vlahovic8; Eleftherios Zografos9; Sean O’donnell10; Zsolt Szijgyarto9;

Volker Heinemann11

1Division of Solid Tumor Oncology, Memorial Sloan Kettering Cancer Center,

New York, USA

2Sorbonne University, Pitié Salpêtrière Hospital, APHP, Frankreich

3Vall d’Hebron University Hospital and Vall d’Hebron Institute of Oncology

(VHIO), Barcelona, Spanien

4The Royal Marsden Hospital, London, United Kingdom

5University Health Network, Toronto, Ontario, Kanada

6Fondazione IRCCS – Istituto Nazionale dei Tumori, Milan, Italien

7National Cancer Center Hospital East, Chiba, Japan

8GSK, MA, USA

9GSK, Stevenage, United Kingdom

10GSK, Collegeville, PA, USA

11Comprehensive Cancer Center Munich, LMU Klinikum Munich, Munich,

Deutschland

Background: In patients (pts) with locally advanced rectal cancer (RC),

organ-sparing non-operative management (NOM) following a clinical

complete response (cCR) to treatment (Tx) avoids the potential com-

plications and quality of life impact associated with surgery/chemoradi-

otherapy. Although neoadjuvant chemotherapy is standard Tx, pts with

mismatch repair decient (dMMR) tumors respond poorly. Ecacy of the

programmed death (PD)-1 inhibitor, dostarlimab in previously untreated

pts with locally advanced dMMR RC was evaluated in a Phase II study. All

12 pts who completed 6 months (mo) of Tx had cCR and received NOM,

with no Grade ≥3 adverse events reported [1]. AZUR-1 will evaluate the

ecacy and safety of dostarlimab in pts with previously untreated locally

advanced dMMR/microsatellite instability-high (MSI-H) RC.

Methods: AZUR-1 (NCT05723562) is a global, multicenter, single-arm,

open-label, Phase II study (target N= ~100). Key eligibility criteria: age

≥18 years, no prior radiation/systemic Tx/surgery for RC, ECOG 0–1, and

no tumor-caused symptomatic bowel obstruction. Pts must have a tumor

with dMMR status/MSI-H phenotype, determined locally/by central ref-

erence laboratory. Dostarlimab 500 mg will be administered intravenously

every 3 weeks for ≤9 cycles. Primary endpoint: cCR by independent cen-

tral review (ICR) at 12 mo, dened as achieving and maintaining cCR for

12 mo. Key secondary endpoints: cCR by ICR at 36 mo, 3-year event-free

survival by investigator assessment, 5-year disease-specic survival, and

5-year overall survival. Pts with cCR by end of Tx will be assessed every

4–6 mo for recurrent disease for 5 years (NOM). Ecacy and safety will

be assessed in all pts who received ≥1 dose of dostarlimab. For a range

of plausible observed cCR12 rates (60–95%) in the primary analyses,

the planned sample size of 100 pts will provide a Clopper–Pearson exact

binomial two-sided 95% condence interval with lower condence limit

within ~10% of the observed cCR12 rate. No interim analyses are planned.

Indication of source:

1. Cercek, A et al. NEJM 2022;386:2363–76.

Disclosure Statement: e authors declare the following: 1Global, AC

BioTech, Acobio,Advanced Accelerator Applications, Amgen, AstraZeneca,

Bayer, Biomunex, BMS, Boehringer Ingelheim, Carsgen, Celgene, Chugai

Pharmaceutical, Daichi, Daiichi Sankyo, Eisai, Eli Lilly Bangladesh, Eli Lilly

ailand, Esteve, Exelixis, FALCO Biosystems, Federal government employee

721

International study on the prevalence of malnutrition

in centralized care for colorectal cancer patients

Carl Meißner1,2; Svenja Tiegges3; Martin Broehl3; Ronny Otto2;

Karsten Ridwelski2,4

1MVZ „Im Altstadtquartier“ GmbH, Magdeburg, Deutschland

2An-Institut für Qualitätssicherung in der operativen Medizin gGmbH,

Magdeburg, Deutschland

3WissWerk Standort Köln, Köln, Deutschland

4Klinikum Magdeburg gGmbH, Klinik für Allgemein- und Viszeralchirurgie,

Magdeburg, Deutschland

Background: e subject of malnutrition is not even consistently

addressed in all clinics or colorectal cancer centers but it is required in the

survey form for colorectal centers. e objective of this multicenter study

was to determine the prevalence of malnutrition in colorectal cancer

centers. Another objective is to investigate possible consequences, such as

complications or length of stay.

Methods: Between 2019 and 2021, patients in colorectal cancer centers

were examined in the preoperative phase. In addition to questions about

patients’ state of health and nutrition, two validated screening forms

were used.

Result: Data records of 3,102 patients were evaluated. Approximately

one-third of patients in colorectal cancer centers suer from malnutrition

preoperatively. e length of stay in hospital and the rate of complications

were signicantly higher when malnutrition was identied. e average

length of stay of patients with complications was approximately twice as

long as the stay of patients who had no complications.

Discussion: Despite the increased prevalence of malnutrition, the most of

the patients were still being discharged to the post-hospitalization setting

without any nutrition therapy. In particular, interdisciplinary support as

well as cooperation in the outpatient sector may have a decisive inuence

on subsequent convalescence. Procedures providing nutrition medicine

and their implementation are explicitly described in the guidelines.

Conclusion: Approximately one in three to four patients with a colorec-

tal carcinoma has an increased risk of malnutrition. Malnutrition has a

signicant impact both on the rate of complications and the length of

stay and may therefore have a decisive inuence on the costs. e results

underscore the need for systematic screening and at the same time should

increase clinics awareness of the importance of establishing a nutrition

management policy.

Disclosure Statement: e authors declare the following: Frau Tiegges

und Herr Broehl sind Mitarbeiter im Wisswerk Köln.

798

Testing for DPYD-polymorphism in upper rectal cancers

(stages ≥II) treated with upfront surgery and FOLFOX – did we

miss something in the past?

Paula Liersch1,2, Sascha Dierks3, Reiner Andag3, Charlotte de Boer4,5,

Torsten Liersch4, Birgit Jünemann4, Andrea Hille6, Julie Schanz2,3

1Department of Preventive Dentistry, Periodontology and Cariology, Göttingen,

Deutschland

2Department of Haematology and Medical Oncology, Göttingen, Deutschland

3Department of Clinical Chemistry, Göttingen, Deutschland

4Department of General, Visceral and Pediatric Surgery, Göttingen, Deutschland

5Department of Internal Medicine, Kiel, Deutschland

6Department of Radiotherapy and Radiation Oncology, Göttingen, Deutschland

Background: In April 2020, the European Medicines Agency (EMA)

recommended testing for the most common DPD-mutations in patients

prior to application of 5-uorouracil (5-FU).

Purpose: Using cryopreserved blood samples of patients with upper

rectal cancers, DPYD-testing was performed to evaluate occult DPYD-

polymorphism and its impact on acute adverse events (AE) and prognosis.

Patients, Material and Methods: 75 participants (median age: 69 yrs,

f: 26, m: 49) of the GAST-05-phase-IIb-trial (ISRCTN35198481) had

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts60

been tested for wildtype (WT) DPYD*2A at staging. Upfront surgery was

performed with total (TME, n=34) or partial (PME, n=41) mesorectal

excision. Postoperatively, FOLFOX (4 cycles; FA: 400 mg/m², 5-FU: 2400

mg/m², OX: 100 mg/m²) was indicated for stages ≥II. Acute AEs had

to be recorded according to NCI-CTC-AE grading. Survival was calcu-

lated using the Kaplan-Meier method. DPYD-re-testing was performed

according to well-established methods blinded to the clinical data.

Results: DPYD re-testing revealed 100% WT for DPYD*2A, DPYD*13

and the polymorphism c.2846A>T. Interestingly, in 5 (10%) patients

receiving CTx a DPYD-Hap B3 status was detected. For 43 patients

treated with FOLFOX, CTx-adherence (from cycle 1 to 4) was 100.0%,

97.7%, 95.3% and 93.0%, respectively. For patients with DPYD-WT, dos-

ages of 5-FU and OX had been administered in 92.6% and 75.3%, and

for HapB3-patients in 68.8% and 55.0% of the target, respectively. In

total of 612 AEs (all grades) with 28.9% hematologic, 27.6% gastroin-

testinal, 17.3% neurologic and 0.5% cardiac events, AEs grade 3/4 had

occurred in 3.3%. During follow-up (95%CI: 62.1; 130.8 months), recur-

rences were diagnosed for DPYD-WT- and HapB3-patients in 36.8% and

80.0%, respectively. For WT patients, pairwise testing showed better DFS

(p=0.010), but not OS (p=0.296).

Conclusion: DPYD-re-testing in rectal cancer patients detected occult

HapB3 mutations, its impact remains unclear.

Discussion: Further results will be presented in detail.

Disclosure Statement: e authors declare no conict of interest.

814

The role of SCD1 in colorectal cancer progression and its

potential as a therapeutic target

Paulina Pittrich1; Josef Ecker2; Klaus-Peter Janssen1

1Klinikum Rechts der Isar, München, Deutschland

2ZIEL - Zentralinstitut für Ernährungs- und Lebensmittelforschung, Freising,

Deutschland

Background: Metabolic reprogramming including activation of lipogen-

esis has been established as a hallmark of solid cancer. We have shown

previously that the lipidome is specically altered in human colorectal

cancer, which correlates with prognosis. One key enzyme upregulated

in this context is the stearoyl-CoA-desaturase-1 (SCD1), which is not

expressed in healthy digestive epithelia. SCD1 is essential for the produc-

tion of monounsaturated fatty acids and crucially involved in cancer for-

mation. However, the molecular mechanisms leading to an upregulation

of SCD1 in the tumor context, and its involvement in carcinogenesis, are

still unclear.

Methods: SCD1 expression was quantied in 110 colorectal carcinoma

patient tissues by qPCR and immunoblot analysis. Patients from all tumor

stages including liver metastasis were analyzed. For in vitro analyses,

various cellular assays with SCD1-decient human colorectal cancer cell

lines HCT116 and DLD1 were performed, such as proliferation, migra-

tion and chorion allantois membrane assay (CAM).

Result: Compared to healthy colon mucosa, intratumoral mRNA and

protein expression of SCD1 was signicantly increased, whereas SCD1

expression in liver metastasis was signicantly decreased, compared to

the primary tumors, and to healthy liver parenchyma. SCD1-decient

HCT116 cells showed signicantly reduced cell proliferation and 2D cell

migration, compared to parental cells. e invasion capacity and angio-

genic potential of SCD1-decient clones was reduced compared to paren-

tal cells in a CAM assay.

Discussion: ese results indicate that SCD1 is essential for colorectal

cancer metabolism and therefore its survival and aggressiveness. Why its

expression is decreased in matching liver metastasis is a question which

needs to be further addressed.

Conclusion: SCD1 plays a major role in colorectal cancer, by increasing

cell proliferation under cell stress conditions. Increased SCD1 expression

correlates with higher metastasis rate and poorer outcome.

Disclosure Statement: e authors declare no conict of interest.

818

Phase 3 study of tucatinib, trastuzumab, and modied

FOLFOX6 as rst-line treatment in HER2+ metastatic

colorectal cancer (MOUNTAINEER-03, trial in progress)

Volker Heinemann1; Thierry André2; Tanios Bekaii-Saab3; Andrea Cercek4;

Yoshiaki Nakamura5; Kanwal Raghav6; Salvatore Siena7; John Strickler8;

Eric Van Cutsem9; David Adelberg10; Jorge Ramos11; Shan Yang11;

Takayuki Yoshino5; Josep Tabernero12

1Comprehensive Cancer Center at Ludwig Maximilian University of Munich,

Munich, Deutschland

2Sorbonne Université et INSERM ‘Instabilité des Microsatellites et Cancer,

Hôpital Saint Antoine, Paris, Frankreich

3Mayo Clinic, Scottsdale, AZ, USA

4Memorial Sloan Kettering Cancer Center, New York, NY, USA

5National Cancer Center Hospital Japan East, Kashiwa, Japan

6MD Anderson Cancer Center, Houston, TX, USA

7Grande Ospedale Metropolitano Niguarda and Università degli Studi di Milano,

Milan, Italien

8Duke University Medical Center, Durham, NC, USA

9University Hospital Gasthuisberg and University of Leuven, Leuven, Belgien

10Merck & Co., Inc., Kenilworth, NJ, USA

11Seagen Inc., Bothell, WA, USA

12Vall D’Hebron University Hospital and Institute of Oncology (VHIO), Barcelona,

Spanien

Background: Current standard of care (SOC) for treatment of metastatic

colorectal cancer (mCRC) is multi-agent chemotherapy, +/- a VEGF or

EGFR inhibitor. HER2 amplication occurs in 3%-5% of mCRC patients

(pts), and ~5-14% of pts with RAS/BRAF wild-type (WT) mCRC tumors.

Tucatinib (TUC), a highly selective, HER2-directed tyrosine kinase inhib-

itor, is approved in multiple regions for HER2+ metastatic breast cancer

and is being investigated in gastrointestinal cancers. MOUNTAINEER

(NCT03043313) evaluated safety and ecacy of TUC and trastu-

zumab (T) in pts with treatment-refractory RAS WT HER2+ mCRC.

Results from the primary analysis showed clinically meaningful activ-

ity (conrmed objective response rate of 38.1% and median duration of

response of 12.4 months) and demonstrated TUC + T was well tolerated.

MOUNTAINEER-03 will investigate TUC plus modied FOLFOX6 + T

in pts with RAS WT, HER2+ mCRC.

Methods: MOUNTAINEER-03 (NCT05253651) is a global, open- label,

randomized, phase 3 study for rst-line treatment of HER2+ and RAS

WT locally advanced/unresectable or mCRC. ~400 adult pts will be

randomized 1:1 to TUC experimental arm (TUC [300 mg PO BID] + T

+ modied FOLFOX6) or the SOC arm (modied FOLFOX6 alone or

in combination with either bevacizumab or cetuximab).HER2 status is

determined centrally with tissue-based HER2 immunohistochemistry

and in situ hybridization. Pts may have received maximum 2 doses of

mFOLFOX6 in locally advanced/unresectable or metastatic setting prior

to randomization and may have received adjuvant treatment if completed

>6 months prior to enrollment. Randomization is stratied by primary

tumor location (le-sided vs other), liver metastases and number of doses

of mFOLFOX6 chemotherapy prior to randomization. Primary endpoint

is progression-free survival. Key secondary endpoints are overall survival

and conrmed objective response rate. Enrollment is ongoing in Europe,

and all other regions.

is abstract was previously presented at ESMO 2022, Final Publication Number:

1037, by ierry Andre (reused with permission).

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 61

852

A novel approach to enhance FOLFOX therapy in colorectal

cancer: combination of FASN inhibition and chemotherapeutic

agents

Fabian Beck1; Klaus-Peter Janssen1; Josef Ecker2

1Klinkum rechts der Isar, München, Deutschland

2Technische Universität München, München, Deutschland

Background: Altered lipid metabolism is noted in lots of tumor entities,

e.g. colorectal cancer (CRC). Fatty Acid Synthase (FASN) is one of the key

enzymes of lipid synthesis and is oen upregulated in CRC. is suggests

its inhibition as a target for chemotherapy, e.g. with a typical inhibitor

Cerulenin. Another FASN-Inhibitor, TVB-2640, is already undergoing a

clinical trial for breast cancer (Phase II) and CRC (Phase I). However, the

common treatment concept for CRC has not changed yet. e standard

FOLFOX scheme for CRC contains the chemotherapeutics Oxaliplatin

and 5-Fluoruracil (5ʹFU). erefore, this project aims to combine FASN-

Inhibition and FOLFOX to signicantly increase the eciency in colorec-

tal cancer.

Methods: To unravel this hypothesis, CRC cell lines and patient-derived

tumor and normal mucosa organoids, isolated aer surgery from pri-

mary tissue, were treated with FASN-Inhibitors, Oxaliplatin and 5ʹFU.

Metabolic and apoptosis marker were analyzed based on gene and protein

level, as well as by Sytox/Höchst immunouorescence staining.

Result: Preliminary results show that Cerulenin enhances the eect of

5ʹFU and Oxaliplatin in established CRC cell lines and patient-derived

organoids. Additionally, the analysis of treated HCT116 revealed that

standard chemotherapeutics induce a higher metabolic change than

Cerulenin.

Discussion: e increase in cell death of the organoids by addition of

Cerulenin to standard chemotherapeutics indicates that the combination

treatment could open a window for an addition to the reliable FOLFOX

treatment scheme.

Conclusion: However, many open questions regarding the combina-

tion of FASN-Inhibition, Oxaliplatin and 5`FU remain unanswered. An

optimized duration and concentration need to be determined as well as

the safety aspect on normal tissue has to be considered. To understand

the mechanism of action, pathway analysis will be included in future

experiments.

Disclosure Statement: e authors declare no conict of interest.

865

The role of NOTCH-signaling in mediating therapy resistance

in rectal cancer

Melanie Spitzner1; Alena Siebert1; Gizem Chelik2; Michael Ghadimi1;

Günter Schneider1; Jürgen Wienands2; Marian Grade1

1Department of General, Visceral and Pediatric Surgery, UMG, Göttingen,

Deutschland

2Institute of Cellular and Molecular Immunology, UMG, Göttingen, Deutschland

Background: Rectal cancer is associated with high morbidity and mortal-

ity rates aecting both men and women worldwide. In this context, resis-

tance to chemoradiotherapy (CRT) remains a major clinical dilemma.

erefore, it is important to uncover the molecular mechanisms under-

lying CRT resistance in rectal cancer in order to identify personalized

treatment strategies.

Methods: Gene expression levels of selected NOTCH pathway compo-

nents was obtained from microarray data of 207 rectal cancer patients,

treated with preoperative CRT, and correlated with their respective clini-

cal data. e relevance of NOTCH protein expression was further evalu-

ated in two rectal cancer cell lines (SW837, SW1463) and one colon cancer

cell line (LS411N) by Western blotting. Aer inhibition of the individual

NOTCH isoforms by RNAi technique, these cell lines were subjected to

colony formation assays in the absence or presence of CRT, which is the

standard assay in the eld to monitor treatment sensitivity.

Result: e microarray data underlined the intrinsic gene expression

heterogeneity in patients regarding their NOTCH prole. e NOTCH-

signature was associated with clinical outcome: Patients with a NOTCH-

low signature (n=52) showed a favorable disease-free survival (DFS)

compared to those with a NOTCH-high signature (n=155). In vitro, we

tested the NOTCH-negative cell line LS411N and the NOTCH-positive

cell lines SW837 and SW1463. CRT-resistant SW837 and SW1463 rectal

cancer cells showed increased sensitivity to therapy following the down-

regulation of individual NOTCH isoforms.

Discussion and Conclusions: Overall, these data demonstrate that high

levels of NOTCH receptors are associated with treatment resistance and

impaired disease-free survival. erefore, if further validated, inhibition

of NOTCH signaling may represent an alternative treatment option.

Disclosure Statement: e authors declare no conict of interest.

892

A contemporary assessment of total neoadjuvant therapy

(TNT) protocols for locally advanced rectal cancer: adoption

and expert perspectives at German Cancer Society (DKG)

certied colorectal cancer centers

Melanie C. Langheinrich1; Christoph Paasch2; René Mantke2; Klaus Weber3;

Stefan Benz4; Stephan Kersting1

1Universitätsmedizin Greifswald, Greifswald, Deutschland

2Universitätsklinikum Brandenburg an der Havel, Brandenburg, Deutschland

3Universitätsklinikum Erlangen, Erlangen, Deutschland

4Klinikverbund Südwest, Böblingen, Deutschland

Background: e approach to treating locally advanced rectal cancer

(LARC) has remarkably evolved. Total neoadjuvant therapy (TNT) is a

novel concept, which administered systemic chemotherapy in the neoad-

juvant setting, before or aer chemoradiotherapy (CRT) or short course

radiotherapy (SCRT).

Methods: A comprehensive online questionnaire, constituted of 14 TNT

queries targeting patients with LARC, was conducted among DKG certi-

ed colorectal cancer centers registered within the database of the Addz

(Arbeitsgemeinscha Deutscher Darmzentren) between December 2022

and January 2023.

Result: A third of the centers participated in patient enrollment for a TNT

study, 84% of centers reported treating patients in an analogous manner.

e decision to adopt a TNT approach was inuenced by factors such

as: lower third of the rectum, cT4 stage, and a positive circumferential

resection margin. Furthermore, there appears to be uncertainty in regard

to a clinical complete response (cCR) and the “Watch and Wait” (W&W)

approach. Some centers adopt the watch-and-wait approach (42%), others

only utilize it when extirpation is otherwise necessary (39%), and a por-

tion still proceed with surgery as initially planned (19%).

Discussion: Our ndings reveal that TNT is already being implemented

in clinical practice. Remarkably, TNT is mostly being performed out-

side of clinical trials. e survey also addressed the W&W approach in

the context of handling patients who achieve cCR. e ndings clearly

demonstrated diering perspectives and a lack of consensus on this

approach among the respondents.

Conclusion: is study presents an overview of current clinical practice

within DKG certied German colorectal cancer centers. It is noteworthy

that TNT is predominantly performed outside of clinical trials. Across

the centers there is signicant heterogeneity in handling clinical complete

response and adopting the W&W approach. Further research is needed

to establish standardization in the care of locally advanced rectal cancer.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts62

897

Adherence and acute toxicities in total neoadjuvant treatment

(TNT) of locally advanced rectal cancer (LARC)

Timotheus Ritter-Vanoorop1; Jana Nele Leoni Vanoorop1;

Andreas Leha2; Johanna Kreutzer1; Heiko Sülberg3; Philipp Schüler1;

Torsten Liersch1

1Klinik für Allgemein-, Viszeral- und Kinderchirurgie - Universitätsmedizin

Göttingen, Göttingen, Deutschland

2Institut für Medizinische Statistik - Universitätsmedizin Göttingen, Göttingen,

Deutschland

3X-act Cologne Clinical Research GmbH, Köln, Deutschland

Background: Adjuvant chemotherapy (CTx) aer neoadjuvant chemora-

diation (CRT) and total mesorectal excision (TME) in patients with LARC

is associated with high rates of CTx-non-performance, acute adverse

events (AE), dose reductions or treatment disruption. In part to increase

adherence to CTx, ongoing trials are using total neoadjuvant treatment

(TNT) upfront TME.

Methods: In this single center analysis, LARC patients treated

according to the multicenter TransValid-B-phase-I/II-trial (WHO-

UTN-U1111-1132-0235) were included. TNT was performed with

irradiation (28x1.8 Gy; in total 50.4 Gy) and concomitant infusion of

5-uorouracil (5-FU; 250 mg/m2/d, d1 - d14 and d22 - d35) and oxal-

iplatin (OX; 50 mg/m2 on d1, d8, d22 and d29). 4 weeks later, 3 cycles

FOLFOX were applied with OX (80-100 mg/m2), folinic acid (400 mg/m2)

and 5-FU (2400 mg/m2, civ over 46h) on d1, d15 and d30. TME was per-

formed 5 weeks later. Acute toxicities were recorded separately for each

TNT-modul according to NCI-CTC-AE criteria.

Result: 38 patients (7 f, 31 m, median age 63 years) with LARC (< 12 cm

from anal verge), stages III / IV in 92.1% and 7.9%, were assessed. During

CRT, total planned dose was applied in 97.4% (RT) and 94.7% (CTx).

Acute toxicity of grade ≥ 3 was reported in 26.3%, mainly as proctitis,

OX-associated neuropathy, diarrhea and dermatitis. Planned dose of

FOLFOX-CTx could be administered in 83.3%; all patients received

≥ 75% of the planned dose. During CTx, AEs (grade ≥ 3) were recorded in

13.9%. In particular, neuropathy (OX) and leukopenia (5-FU) were noted.

No patient discontinued CTx. AEs (grade ≥ 3) occurred in 35.3% aer

TME surgery (14.7% anastomotic leaks, 11.8% bladder voiding disorders).

A more detailed breakdown of the range of toxicities and the reasons for

dose reductions will be presented at DKK 2024.

Discussion: NeoCTx as part of TNT is safe and feasible; it is associated

with higher adherence and lower toxicity compared to conventional

adCTx as applied in larger clinical trials, the backbone of treatment

guidelines.

Conclusion: In multimodal treatment of LARC, neoCTx should be

preferred.

Disclosure Statement: e authors declare no conict of interest.

902

Multimodal treatment (MMT) in locally advanced rectal

cancers (LARCs): do acute surgical complications have an

impact on long-term survival?

Jana Nele Leoni Vanoorop1; Timotheus Ritter-Vanoorop1;

Johannes Martens1; Johanna Kreutzer1; Andreas Leha2; Heiko Sülberg3;

Torsten Liersch1

1Klinik für Allgemein-, Viszeral- und Kinderchirurgie - Universitätsmedizin

Göttingen, Göttingen, Deutschland

2Institut für Medizinische Statistik - Universitätsmedizin Göttingen, Göttingen,

Deutschland

3X-act Cologne Clinical Research GmbH, Köln, Deutschland

Background: Ongoing trials prefer total neoadjuvant treatment (TNT)

instead of standard chemoradiation (CRT) followed by total mesorectal

excision (TME) and adjuvant chemotherapy (CTx) for LARC to increase

pCR-rates, survival and MMT adherence. Due to this, what is the impact

of intensied neoadjuvant therapy on acute toxicities?

Methods: In these analyses, monocentric patients of the TransValid-A-

(NCT03034473; Arm A) and -B-phase-I/II-trial (WHO-UTN-U1111-

1132-0235; Arm B) were included. Standard treatment (Arm A) was

performed with 5-FU-based CRT, followed by TME and 5-FU- or FOLFOX-

CTx. TNT (Arm B) was performed with irradiation (28x1.8 Gy; in total

50.4 Gy) and concomitant infusion of 5-FU (250 mg/m2/d, d1 - d14 and

d22 - d35) and oxaliplatin (OX; 50 mg/m2 on d1, d8, d22 and d29). 4 weeks

later, 3 cycles FOLFOX were applied with OX (80-100 mg/m2), folinic acid

(400mg/m2) and 5-FU (2400 mg/m2, civ over 46h) on d1, d15 and d30. TME

was performed 5 weeks later. Acute toxicities were recorded separately for

each modality according to NCI-CTC-AE criteria.

Result: 60 (Arm A) and 62 (Arm B) patients with LARC (< 12 cm from anal

verge), stages II-IV in 8.3%, 88.4% and 3.3% (A) and 1.6%, 90.3% and 8.1%

(B), resp., were included. 54 (A) and 58 (B) patients underwent TME surgery.

In both cohorts, postsurgical AEs (grades ≥ 2) within 30 days aer TME

occurred in 50%, mainly as bladder voiding disorders (BVD) in 13.0% vs

32.7%, wound healing disorders (WHD) in 20.5% vs 18.9% and anastomotic

leaks (AL) in 13.0% vs 29.3%. Grade ≥ 3 complications occurred in 20.4%

vs 31.0%, mainly as WHD in 11.2% vs 6.9% and AL in 9.3% vs 10.3%. More

detailed results will be presented at DKK 2024.

Discussion: e avoidance as well as management of postsurgical compli-

cations in LARC patients is important, but the TNT sequence oers both,

a higher adherence to systemic treatment (CTx) and adequate time for

reconstitution of postsurgical AEs.

Conclusion: TNT seemed to be associated with a higher rate of postsur-

gical AEs (all grades), but the management of AEs (grade ≥ 3) did not

disturb any further adjuvant CTx (like FOLFOX).

Disclosure Statement: e authors declare no conict of interest.

909

Barriers and facilitators to colorectal cancer screening among

migrants – a scoping review

Diana Wahidie; Alena Allak; Yüce Yılmaz-Aslan; Patrick Brzoska

Witten/Herdecke University, Faculty of Health, School of Medicine, Health

Services Research, Witten, Deutschland

Background: Studies from various European countries show that

migrants participate less frequently in colorectal cancer screening than

the majority population. e aim of the present study was to determine

the barriers that migrants face in seeking colorectal cancer screening and

to identify the factors that facilitate informed decision making regarding

the use of this type of cancer screening.

Methods: A scoping review was performed that comprised all German-

and English-language publications, including “gray” literature, since 2002.

A search strategy was used to search the PubMed, CINAHL, and PsycInfo

databases, as well as Google Search and Google Scholar. Hits were

screened for inclusion or exclusion based on titles, abstracts, and full texts.

Result: 58 publications were included in the analysis of this study. Based

on the results of these publications, 15 categories of barriers and facilita-

tors were identied: access, religion, culture and fatalism, shame, discom-

fort and fear, knowledge and awareness, language and literacy skills, trust

in the health care system, risk perception, education about colorectal can-

cer and screening, cultural sensitivity of the care system, use of multipli-

ers and patient navigators, promotion of self-ecacy, empowerment and

participation, social support, trusting doctor-patient relationship, family

history, legal regulations to improve care structures.

Discussion: e results indicate dierent barriers aecting access to col-

orectal cancer screening for migrants. As a limitation, it should be noted

that a large proportion of the identied articles describe studies con-

ducted in the US and therefore the generalizability of the results to other

countries such as Germany is limited due to the dierent structures in the

health care systems.

Conclusion: Measures addressing access barriers to colorectal cancer

screening for migrants should take into account, in particular, the role of

religious and cultural factors as well as dierent perceptions of disease and

be tailored to migrants’ language skills and limited health literacy.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 63

954

Inuence of diabetes mellitus on the early postoperative

andlong-term oncologic outcome in surgical therapy of

coloncancer

Juliane Kuehnel1; Romy Kreyer1; Ronny Otto2; Ingo Gastinger2;

Roland Croner1; Frank Meyer1

1Dept. of General, Abdominal, Vascular and Transplant Surgery; University

Hospital, Magdeburg, Deutschland

2Institute of Quality Assurance in Operative Medicine, Otto-von-Guericke

University, Magdeburg, Deutschland

Background: Less is known about the impact of diabetes mellitus (DM)

on the postop. outcome in surgical therapy of colon cancer (Ca).

Methods: Prospective multicenter observational study (62 items) over 3

years (2009-2011)

Result: In total, 9,167 patients (pats) were enrolled in the study who were

subclassied into 20.5% diabetic pats (37.8% of them insulin-dependent)

& 79.5% non-diabetic pats (median age of DM/non-DM pats, 73.7 vs. 70.6

[range, 34-97/18-98] yr. – p<0.001; sex ratio [male/female]: 52.9/47.1 vs.

56.2/43.8% - p<0.001). At the time of Ca diagnosis-nding, diabetic pats

already had a sign. higher level of tumor inltration & therefore a higher

UICC level. In addition, DM pats had a signicant higher ASA scoring than

non-DM pats (p<0.001). In particular, insulin-dependent pats showed higher

ASA scorings, such as III-IV. In an overall morbidity of 35.8%, sign. more

general complications were documented in DM pats (p<0.001). Specic

complications were also higher in DM pats but only by trend. Considering

the total hospital lethality of 4.2%, DM pats had a sign. higher rate. In detail,

insulin-dependent pats (5.8%) were found with a sign. higher hospital lethal-

ity compared with non-insulin-dependent pats (5.0%, p<0.001). In compar-

ison to non-diabetic pats, diabetic pats had a signicantly lower 5-yr-overall

survival (OAS) (59.7% vs. 49.8%, p<0.001). Especially, insulin-dependent

DM pats showed a sign. lower 5-yr-OAS of 44.9% compared to 52.7% (w/

no need for insulin; p<0.001). In summary, multivariable analysis identied

DM, in particular, insulin-dependent DM, as an independent risk factor of a

worse 5-y-OAS (HR=1.24 [95-CI: 1.10-1.38]; p<0.001) and 5-yr-disease-free

survival (DFS) (HR=1.23 [95-CI: 1.07-1.41]; p=0.004).

Conclusion: A higher postop. complication rate as well as a lower

5-yr-OAS and 5-yr-DFS were found in diabetic pats. Insulin-dependent

diabetics & the higher risk potential of DM pats may have the potential for

a disfavorable long-term outcome.

Disclosure Statement: e authors declare no conict of interest.

962

Upfront surgery in upper rectal cancer (UICC-II/III) followed

byFOLFOX – adverse events and survival

Philine-Sophie Hoyer; Charlotte de Boer; Johannes Martens;

Laura Regina Werle; Luca-Patrice Borgwardt; Johanna Kreutzer;

Julie Schanz; Timotheus Ritter; Andreas Leha; Torsten Liersch

Universitätsmedizin Göttingen, Göttingen, Deutschland

Background: In this single site analyses, we evaluate safety, feasibil-

ity, and ecacy of FOLFOX in patients of the GAST-05 phase-IIb trial

(ISRCTN35198481) with upper rectal cancer (stages II/III, ≥12 cm above

anal verge) following peri-/postoperatively quality controlled total vs par-

tial mesorectal excision (TME vs PME).

Methods: 98 patients (median age: 69 years, range: 38 – 87 years) under-

went upfront surgery followed by 4 cycles FOLFOX (FA: 0.4 g/m², 5-FU:

2.4 g/m², OX: 0.1 g/m²) aer conrmation of UICC stages II/III. e

occurrence of acute/late adverse events (NCI-CTC-AE grades 1 to 4, vs 3.0)

was recorded. Survival was calculated using the logrank test, Kaplan-Meier

estimator, and multivariable Cox proportional hazard regression models.

Results: 79.5% patients (stages II/III in 30 and 32 pats) started adCTx

which was applied in 96.6%. In total, 772 AEs (all grades) occurred,

mainly due to hematologic (26.6%), gastrointestinal (GI) (28.6%),

and neurologic (19.6%) AEs. During follow-up (in median >5 years),

chronic neurotoxicity was present in 24.4% and diarrhea in 34.7%. A low

anterior resection syndrome (LARS, all grades) was diagnosed in 44.1%

and most frequent aer TME (p=0.007). e presence of LARS did not

depend on the application of CTx (p=0.209). Stage III patients showed

5-year DFS of 65.6% (vs. 40.0% without adCTx; p=0.058); 5-year OS

was 78.1% (vs. 40.0% without adCTx, p=0.003) and 8-months land-

mark analyses conrmed a benet in OS aer adCTx (p = 0.0043).

However, further analyses of LARS and its impact (esp. on QoL) will be

presented at DKK 2024 in detail.

Discussion: Although patients showed improved survival rates aer

upfront surgery and FOLFOX, the dominating gastrointestinal AEs

should not be overlooked. With LARS occurring in 44.1%, we suggest

screening patients at staging, during MTT and at follow-up visits.

Conclusion: Aer upfront surgery in upper rectal cancer (stage III)

FOLFOX oers improved OS and is associated with a tolerable safety pro-

le and high adherence.

Disclosure Statement: e authors declare no conict of interest.

Gastrointestinal Cancer: other than colorectal

Characterization of long-term survivors in the TOPAZ-1 study

of durvalumab or placebo plus gemcitabine and cisplatin

inadvanced biliary tract cancer

Fabian Finkelmeier1; Mohamed Bouattour2; Juan Valle3; Arndt Vogel4;

Jin Won Kim5; Masayuki Kitano6; Jen-Shi Chen7,8; Howard Burris9;

Renata Zaucha10; Shukui Qin11; Ludovic Evesque12; David B. Zhen13;

Vineet Govinda Gupta14; Joon Oh Park15; Magdalena Żotkiewicz16;

Nana Rokutanda17; Gordon Cohen17; Do-Youn Oh18

1Department of Gastroenterology, Hepatology and Endocrinology, University

Hospital Frankfurt, Frankfurt, Deutschland

2Department of Liver Cancer Unit, Assistance Publique–Hôpitaux de Paris

Hôpital Beaujon, Paris, Frankreich

3Division of Cancer Sciences, The University of Manchester/The Christie NHS

Foundation Trust, Manchester, United Kingdom

4Gastroenterology, Hepatology and Endocrinology, Hanover Medical School,

Hanover, Deutschland

5Division of Medical Oncology, Department of Internal Medicine, Seoul National

University Bundang Hospital, Seoul National University College of Medicine,

Seongnam, Republik Korea

6Second Department of Internal Medicine, Wakayama Medical University,

Wakayama, Japan

7Department of Hematology-Oncology, Linkou Chang-Gung Memorial Hospital,

Tao-yuan City, Taiwan

8Chang-Gung University, Tao-yuan City, Taiwan

9Sarah Cannon Research Institute, Tennessee Oncology, Nashville, USA

10Department of Oncology and Radiotherapy, Medical University of Gdańsk,

Gdańsk, Polen

11Cancer Center of Nanjing, Jinling Hospital, Nanjing, China, VR

12Le Centre Antoine Lacassagne, Département d’Oncologie Médicale, Nice,

Frankreich

13Division of Medical Oncology, Department of Medicine, University of

Washington, Fred Hutchinson Cancer Center, Seattle, USA

14Artemis Hospitals, Gurugram, Indien

15Division of Hematology-Oncology, Department of Medicine, Samsung Medical

Center, Sungkyunkwan University School of Medicine, Seoul, Republik Korea

16AstraZeneca, Warsaw, Polen

17AstraZeneca, Gaithersburg, USA

18Division of Medical Oncology, Department of Internal Medicine, Seoul

National University Hospital, Cancer Research Institute, Seoul National

University College of Medicine, Seoul, Republik Korea

Background: TOPAZ-1 (NCT03875235; data cut-o [DCO] Aug 11,

2021), durvalumab (D) + gemcitabine & cisplatin (GC) signicantly

improved overall survival (OS) vs placebo (P) + GC in patients (pts) with

advanced biliary tract cancer (BTC), with OS curves that separated over

time (Oh et al. NEJM Evid 2022), and persisted with further follow-up

(DCO Feb 25, 2022; HR=0.76 [95% CI, 0.64–0.91]; 18-month OS, 34.8%

[D + GC] vs 24.1% [P + GC]; Oh et al. Ann Oncol 2022 Abs 56P). We

characterized long-term survivors (LTS).

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts64

Methods: Pts untreated for unresectable locally advanced, recurrent or

metastatic BTC received D (1500 mg every 3 weeks [Q3W]) or P, + G

(1000 mg/m2) and C (25 mg/m2) on days 1 and 8 Q3W for ≤8 cycles,

followed by D (1500mg Q4W) or P. Characteristics and outcomes of LTS

(alive ≥18 months aer randomization; DCO Feb 25, 2022) were assessed.

Result: ere were more LTS with D + GC vs P + GC. Characteristics of LTS

were consistent with the full analysis set (FAS, all randomized pts) includ-

ing age, sex, region, primary tumor location, metastatic vs locally advanced

BTC and PD-L1 status. Recurrent BTC was more oen than initially unre-

sectable BTC in LTS vs FAS. Median exposure to study therapy in months

was 11.3 (D), 9.7 (P) and 5.5 (GC, both arms) in LTS vs 7.3 (D), 5.8 (P) and

5.1 (GC, both arms) in FAS. e objective response rate in LTS was 44.3%

for D + GC vs 33.8% for P + GC, and greater for both groups vs FAS (26.7%,

D + GC; 18.7%, P + GC). A higher proportion of LTS in the P + GC group

received subsequent anticancer therapy, including immunotherapy, than

LTS in the D + GC group. Frequency of treatment-related adverse events

leading to discontinuation in LTS was consistent with FAS.

Discussion: -

Conclusion: In TOPAZ-1, characteristics of LTS were generally consistent

with the FAS. Overall, LTS were more common with D + GC; LTS in the

P+ GC group appear to be associated with higher frequency of subse-

quent treatments, including immunotherapy.

with permission. is abstract was previously presented at the 2023 ASCO-GI

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

Nivolumab (NIVO) plus chemotherapy (chemo) vs

chemo as rst-line (1L) treatment for advanced gastric

cancer/gastroesophageal junction cancer/esophageal

adenocarcinoma (GC/GEJC/EAC): 3-year follow-up from

CheckMate 649

Markus Möhler1; Yelena Y. Janjigian2; Kohei Shitara3; Marcelo Garrido4;

Carlos Gallardo5; Lin Shen6; Kensei Yamaguchi7; Lucjan Wyrwicz8;

Tomasz Skoczylas9; Arinilda Bragagnoli10; Tianshu Liu11;

Mustapha Tehfe12; Elena Elimova13; Ricardo Bruges14; James M. Cleary15;

Michalis Karamouzis16; Samira Soleymani17; Ming Lei17;

Carlos Amaya Chanaga17; Jaer A. Ajani18

1Johannes-Gutenberg University Clinic, Maniz, Deutschland

2Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College,

New York, NY, USA

3National Cancer Center Hospital East, Kashiwa, Japan

4Clinica San Carlos de Apoquindo, Ponticia Universidad Católica, Santiago,

Chile

5Fundación Arturo López Pérez, Providencia, Chile

6Department of Gastrointestinal Oncology, Key Laboratory of Carcinogenesis

and Translational Research (Ministry of Education/Beijing), Peking University

Cancer Hospital & Institute, Beijing, China, VR

7The Cancer Institute Hospital of JFCR, Tokyo, Japan

8Klinika Onkologii i Radioterapii, Narodowy Instytut Onkologii, Warszawa, Polen

9II Klinika Chirurgii Ogólnej, Gastroenterologicznej i Nowotworów Układu

Pokarmowego, Medical University of Lublin, Lublin, Polen

10Fundacao Pio Xii Hosp Cancer De Barretos, Barretos, Brasilien

11Zhongshan Hospital Fudan University, Shanghai, China, VR

12Oncology Center–Centre Hospitalier de l’Universite de Montreal, Montreal,

Canada

13Princess Margaret Cancer Centre, Toronto, Kanada

14Instituto Nacional de Cancerologia E.S.E., Bogotá, Kolumbien

15Dana Farber Cancer Institute, Boston, MA, USA

16Laiko General Hospital of Athens, Athens, Griechenland

17Bristol Myers Squibb, Princeton, NJ, USA

18The University of Texas MD Anderson Cancer Center, Houston, TX, USA

Background: NIVO + chemo demonstrated superior overall survival

(OS) and clinically meaningful progression-free survival (PFS) benet vs

chemo and acceptable safety in previously untreated patients (pts) with

advanced GC/GEJC/EAC, leading to approvals in multiple countries.

We present ecacy and safety analyses from the 3-year follow-up of

CheckMate 649.

Methods: Adults with previously untreated, unresectable advanced, or

metastatic GC/GEJC/EAC were enrolled, regardless of programmed

death ligand 1 (PD-L1) expression, excluding pts with known HER2-

positive status. Pts were randomized to NIVO (360 mg Q3W or 240 mg

Q2W) + chemo (XELOX Q3W or FOLFOX Q2W), NIVO + ipilimumab,

or chemo. Primary endpoints for NIVO + chemo vs chemo were OS and

PFS by blinded independent central review in pts with PD-L1 combined

positive score (CPS) ≥ 5.

Results: 1581 pts were concurrently randomized to NIVO + chemo or

chemo. Aer 36-month (mo) minimum follow-up, median OS with

NIVO + chemo vs chemo for PD-L1 CPS ≥ 5 was 14.4 mo (95% CI 13.1–

16.2) vs 11.1 mo (95% CI 10.0–12.1; HR 0.70 [95% CI 0.61–0.81]) and for

all randomized was 13.7 mo (95% CI 12.4–14.5) vs 11.6 mo (95% CI 10.9–

12.5; HR 0.79 [95% CI 0.71–0.88]), respectively. Median PFS with NIVO

+ chemo vs chemo for PD-L1 CPS ≥ 5 was 8.3 mo (95% CI 7.0–9.3) vs 6.1

mo (95% CI 5.6–6.9; HR 0.70 [95% CI 0.60–0.81]) and for all randomized

was 7.7 mos (95% CI 7.1–8.6) vs 6.9 mo (95% CI 6.7–7.2; HR 0.79 [95% CI

0.71–0.89]), respectively. Objective response rate (ORR) was higher and

responses were more durable with NIVO + chemo vs chemo (PD-L1 CPS

≥ 5: ORR, 60% vs 45%; median duration of response [mDOR], 9.6 mo

vs 7.0 mo; all randomized: ORR, 58% vs 46%, mDOR, 8.5 mo vs 6.9 mo,

respectively). OS benet with NIVO + chemo was observed across most

prespecied subgroups. No new safety signals were identied.

Discussion: Aer 3 years of follow-up, NIVO + chemo continued to

demonstrate clinically meaningful long-term survival benet with accept-

able safety.

Conclusions: ese results further support using NIVO + chemo as stan-

dard 1L treatment in previously untreated advanced GC/GEJC/EAC.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

Organization, function and gene expression of tertiary

lymphoid structures in pancreatic cancer resembles lymphoid

follicles in secondary lymphoid organs and their abundance is

related to superior survival

Jonas Lehmann1; Martin Thelen1; Simon Schran1; Ella Preugszat1; Maria A.

Garcia-Marquez1; Philipp Lohneis2,3; Heike Löser3,4; Felix Popp5; Stephan

Kruger6; Stefan Böck6; Steen Ormanns6; Christiane J. Bruns5; Alexander

Quaas3; Michael von Bergwelt-Baildon1,6,7; Kerstin Wennhold1;

Hans A. Schlößer1,5

1Center for molecular medicine cologne (CMMC), Köln, Deutschland

2Hämatopathologie Lübeck, Lübeck, Deutschland

3Institute of Pathology, University of Cologne, Faculty of Medicine and

University Hospital Cologne, Köln, Deutschland

4Pathologie Köln-Deutz, Köln, Deutschland

5Department of General, Visceral, Cancer and Transplantation Surgery,

University of Cologne, Faculty of Medicine and University Hospital Cologne,

Köln, Deutschland

6Department of Internal Medicine III, University Hospital, Ludwig Maximilians

University, München, Deutschland

7German Cancer Consortium (DKTK), Heidelberg, Deutschland

Background: Tertiary lymphoid structures (TLS) have been described in

close proximity to tumor areas in a variety of cancer types, where they

are assumed to represent hotspots for T cell and B-cell activation leading

to tumor-specic immune responses. us, abundance of TLS is related

to cancer-specic survival and susceptibility to immune checkpoint

inhibition.

Methods: To identify shared and TLS/secondary lymphoid organ (SLO)-

specic features we performed immunohistochemistry staining and

5-color immunouorescence (IF) of previously untreated pancreatic duc-

tal adenocarcinoma (PDAC) samples. NanoString-based RNA expression

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 65

analysis of laser microdissected tissue was conducted for 12 patients to

compare gene expression in TLS, PDAC, SLOs and normal pancreatic

tissue. B-cell receptor sequencing was performed to determine clonal

expansion.

Result: PDAC patients with a high abundance of TLS inside and sur-

rounding the tumor showed a higher overall survival and TLS abundance

correlated with inltration of T cells in the tumor microenvironment. IF

revealed structural homologies between TLS and SLO with a similar dis-

tribution of B cells, T cells, follicular dendritic cells and lymphatic ves-

sels. In addition, we found largely overlapping expression patterns of a

variety of immune related gene clusters. However, especially expression

levels of T-cell and complement-associated genes were distinct. Most TLS

expressed Ki-67, Pax5, AID and IgG, proving proliferation, class switching

and anity maturation of B cells in close proximity to the tumor. B-cell

receptor sequencing of microdissected TLS and SLO, identied an overlap

of expanded sequences.

Discussion: Our analyses of organization, function and gene expression

patterns revealed a high overlap between SLOs and TLS in PDAC.

Conclusion: ese results indicate a role of TLS in cancer immunosur-

veillance of PDAC, which may be susceptible to therapeutic targeting in

this highly aggressive and immunotherapy-resistant disease.

Disclosure Statement: e authors declare no conict of interest.

140

Health-related quality of life (HRQOL) in patients with

advanced gastric, gastroesophageal junction, or esophageal

adenocarcinoma cancer (GC/GEJC/EAC): 36-month results of

CheckMate 649 nivolumab plus chemotherapy (N+C) vs (C)

Markus Möhler1; Lucjan Wyrwicz2; Clara Chen3; Eric Davenport4;

Jinyi Wang4; Raheel Nathani3; Kaoru Kondo3; Elena Elimova5

1Johannes-Gutenberg University, Mainz, Deutschland

2Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw,

Polen

3Bristol Myers Squibb, Princeton, NJ, USA

4RTI International, Research Triangle Park, NC, USA

5Princess Margaret Cancer Centre, Toronto, Kanada

Background: Primary results of CheckMate 649 showed signiﬁcant

improvement in overall survival (OS) and progression-free survival (PFS)

with rst-line (1L) N+C vs C in patients (pts) with GC/GEJC/EAC and

programmed death ligand 1 (PD-L1) combined positive score (CPS) ≥ 5.

HRQOL was maintained at 24-month (mo) follow-up (FU) and risk of

deterioration was lower with N+C vs C. We report exploratory analyses at

36-mo FU in pts with PD-L1 CPS ≥ 5.

Methods: Functional Assessment of Cancer erapy-Gastric Cancer

(FACT-Ga) and EQ-5D-3L (EQ-5D) were performed at baseline (BL) and

every 6 weeks during treatment. Longitudinal change from BL in EQ-5D

Visual Analog Scale, Utility Index (UI), FACT-Ga total score, and subscales

were analyzed using a mixed model for repeated measures. FACT-Ga GP5

(“I am bothered by side eects of treatment”) item responses were ana-

lyzed descriptively. Time to ﬁrst symptom deterioration (TTSD) and time

until deﬁnitive deterioration (TuDD) were estimated using Kaplan-Meier

estimators and stratiﬁed Cox models; deterioration/improvement was

based on prespeciﬁed thresholds.

Results: 1581 pts were randomized; 955 had PD-L1 CPS ≥ 5, and 822 pts

with both BL and post-BL patient-reported outcomes (N+C, n = 422; C,

n = 400). N+C was favored at most time points for EQ-5D, FACT-Ga total,

Gastric Cancer Subscale (GaCS), and Physical Well-Being scores and were

comparable for other FACT subscale scores. Pts treated with N+C were no

more bothered by side eects than pts treated with C alone. TTSD favored

N+C vs C (HR < 1) and signiﬁcant decreased risk of deterioration, with

HR and 95% CI < 1, was seen in EQ-5D UI, FACT-Ga total score, and

GaCS subscale. TuDD showed signiﬁcant delays in deterioration for all

scale scores (HR and 95% CI < 1).

Discussion: HRQOL scores across measures favored N+C vs C at most

time points. N+C decreased deterioration risk vs C.

Conclusions: e 36-mo FU results conﬁrm the 24-mo FU ﬁndings

that pts generally maintained HRQOL with N+C vs C. Along with the

improvement of OS and PFS, these results suggest favorable beneﬁts for

1L N+C in pts with PD-L1 CPS ≥ 5.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

149

Trastuzumab from ToGA to real world routine practice, report

from North West Cancer Centre Northern Ireland

Hossam Abdulkhalek1; Fatema Mohammad2; Lorna Cairns1; Conor Oneill1

1North West Cancer Centre, Western Health & Social Care Trust, Londonderry,

Northern Ireland

2Ulster University, Coleraine, United Kingdom

Introduction: Oesophageal and gastric cancers are among common can-

cer sites across the world and one year survival rates for oesophageal and

gastric cancer are 23% and 21% respectively. In the pivotal Trastuzumab

for Gastric Cancer (ToGA) trial, Trastuzumab improved median survival

in patients with advanced HER2 positive gastroesophageal cancer from

11.1 to 13.8 months.

Method: Data items for collection were identied through the NICE

guidelines. Datasets from Electronic Case Record were extracted with an

incident date of diagnosis between 01/01/2018 to 31/12/2021. Data ret-

rospectively reviewed and assessed for the Trastuzumab treated group in

comparison to previously published data.

Results: Total of 14 patients with oesophageal, gastroesophageal and

gastric cancer received Trastuzumab. All patients (14/14) had conrmed

HER2 positive stage IV adenocarcinoma (IHC+3). e mean age was 66

years, 71% (10/14) were male, 79% (11/14) had junctional adenocarci-

noma while 21% had gastric adenocarcinoma. Baseline cardiac functions

assessed by obtaining 2D echocardiography in 100% (14/14) patients and

follow up echocardiography obtained in accordance to NICE guidance,

cardiac side eects are recognized in 0% (0/14) patients. Trastuzumab was

discontinued in 57% (8/14) and in 7% (1/14) due to disease progression

or intolerance respectively. 3 patients (21%) are still alive at the time of

the report. Median number of cycles of Trastuzumab was 12 (range 1- 34)

and 57% (8/14) were able to complete 6 cycles of Trastuzumab and che-

motherapy. Median overall survival was 10 months and cumulative 1 year

survival rate was 22%.

Conclusion: e outcome for our patients is comparable to the published

regional and national data. e median survival of our patients treated

with Trastuzumab is less than what was reported in the ToGA trial, how-

ever the number of patients is too small to conclude that. More real-world

studies will oer more insight into our patients’ outcomes.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts66

188

Nal-IRI with 5-uorouracil and leucovorin or gemcitabine plus

cisplatin in advanced biliary tract cancer, a phase 2 study of

the AIO hepatobiliary and YMO cancer groups (NIFE-AIO-YMO

HEP-0315) - updated survival and QoL results

Lukas Perkhofer1; Dominik Paul Modest2; Marianne Sinn3; Jana Käthe

Strieer3; Bernhard Opitz4; Thorsten O. Goetze5; Eike Gallmeier6;

Stefan Angermeier7; Ludwig Fischer von Weikersthal8; Lutz Jacobasch9;

Dirk Waldschmidt10; Michael Niedermeier11; Michael Sohm12;

Disorn Sookthai13; Marina Schaaf13; Axel Hinke14; Thomas Seuerlein1;

Thomas J. Ettrich1

1Universitätsklinikum Ulm, Ulm, Deutschland

2Charité - Universitätsmedizin Berlin, Berlin, Deutschland

3Universitätsklinikum Hamburg Eppendorf, Hamburg, Deutschland

4Krankenhaus St. Elisabeth and St. Barbara Halle, Halle, Deutschland

5Krankenhaus Nordwest, Frankfurt am Main, Deutschland

6Klinikum Memmingen, Memmingen, Deutschland

7Klinikum Ludwigsburg, Ludwigsburg, Deutschland

8Klinikum St. Marien Amberg, Amberg, Deutschland

9Hämatologie/Onkologie Dresden, Dresden, Deutschland

10Uniklinik Köln, Köln, Deutschland

11Hämatologie/Onkologie Memmingen, Memmingen, Deutschland

12Hämatologie/Onkologie Landshut, Landshut, Deutschland

13IKF, Frankfurt am Main, Deutschland

14CCRC Cancer Clinical Research Consulting, Düsseldorf, Deutschland

Background: In the NIFE study the combination of nanoliposomal-irino-

tecan (nal-IRI) plus 5-FU/leucovorin (5-FU/LV) was evaluated as a

1st-line therapy option in advanced biliary tract cancer (BTC), compared

to the standard of care gemcitabine/cisplatin (G/C). Here we present the

updated overall survival data and quality of life evaluation.

Methods: NIFE is a prospective, open label, randomized, multicenter

phase 2 study. Advanced BTC patients were randomized (1:1) to receive

nal-IRI/5-FU/LV (arm A) or G/C (arm B). Stratication parameters were

intrahepatic vs. extrahepatic BTC, sex and ECOG (0/1). e primary

endpoint was progression free survival (PFS) at 4 months in the ITT

and required at ≥50% of subjects being progression free to reject the null

hypothesis in arm A (90% power, type I error 0.05). Quality of life ques-

tionnaires were repetitively recorded throughout the therapy (EORTC

QLQ-BIL21, QLQ-C30).

Result: Between 2018 and 2020 91 patients were randomly assigned to

receive either nal-IRI/5-FU/LV (n=49) or gemcitabine/cisplatin (n=42).

e NIFE trial met its primary endpoint with a 4 months PFS-rate of

51% in patients receiving nal-IRI/5-FU/LV. e exploratory comparison

of the study arms consistently suggested a numerical but statistically not

signicant survival benet for patients receiving nal-IRI/5-FU/LV over

time. Within the study no unexpected toxicities occurred. Change from

baseline was noted in the EORTC QLQ-C30 global health-related quali-

ty-of-life score and showed no clinically meaningful dierences between

both treatment arms. Further detailed QoL analysis is pending.

Discussion: Nal-IRI/5-FU/LV showed ecacy in 1st line therapy of

advanced BTC, however interpretation has to be taken with caution due to

relatively small patient number. erefore, this regimen needs validation

in a larger phase 3 trial.

Conclusion: Treatment with nal-IRI/5-FU/LV consistently demonstrated

ecacy in the 1st-line therapy of advanced BTC with maintained quality

of life.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

304

Perioperative Therapie mit FLOT4 verlängert signikant das

Überleben bei Patienten mit Magenkarzinom und AEG-Tumor

in einer großen Real-World-Kohorte

Christian Möhring1; Adrianna Mańczak1; Aliki Timotheou1;

Farsaneh Sadeghlar1; Taotao Zhou1; Robert Mahn1;

Malte Benedikt Monin1; Marieta Toma2; Georg Feldmann3; Peter Brossart3;

Muemtaz Koeksal4; Gustavo Sarria4; Nils Sommer5; Philipp Lingohr5;

Azin Jafari5; Jörg Kal5; Christian P Strassburg1;

Maria Angeles Gonzalez-Carmona1

1Medizinische Klinik und Poliklinik I - Universitätsklinikum Bonn, Bonn,

Deutschland

2Institut für Pathologie, Bonn, Deutschland

3Universitätsklinikum Bonn Medizin.Klinik III - Hämatologie und Onkologie,

Bonn, Deutschland

4Klinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Bonn,

Bonn, Deutschland

5Klinik und Poliklinik für Allgemeine Chirurgie, Viszeral-, Thorax- und

Gefäßchirurgie, Bonn, Deutschland

Background: Seit 2019 ist das FLOT4 Schema der neue perioperative

Chemotherapiestandard für Patienten mit lokal fortgeschrittenem AEG-

Tumor und Magenkarzinom. Ob sich die Daten der FLOT4-Studie auch

in einem unselektierten Patientenkollektiv reproduzieren lassen, ist bisher

nur unzureichend untersucht. In dieser Arbeit haben wir eine große Real-

World-Kohorte von Patienten mit AEG-Tumor und Magenkarzinom

untersucht und die Eektivität und Verträglichkeit von FLOT4 mit der

von 5-FU/Platinderivat basierten Protokollen verglichen.

Methods: In die retrospektive Studie wurden Patienten mit lokal fortges-

chrittenem AEG-Tumor und Magenkarzinom eingeschlossen, die entweder

perioperativ mittels FLOT4-Protokoll oder 5-FU/Platinderivat basier-

tem Protokoll zwischen 2010 und 2022 im Uniklinikum Bonn behandelt

wurden (n=99). Das Gesamtüberleben, das krankheitsfreie Überleben,

erapieansprechen und erapiekomplikationen wurden analysiert.

Result: Mit FLOT4 behandelte Patienten (n=55) hatten ein statistisch

signikant längeres medianes Gesamtüberleben von 57,8 Monaten ver-

glichen mit 28,9 Monaten unter 5-FU/Platinumderivat (n=44) (HR:

0,554, 95% KI: 0,317 – 0,969, p=0,036). Das mediane krankheitsfreie

Überleben war ebenfalls in der FLOT-Gruppe verlängert, jedoch nicht

statistisch signikant (54,2 vs. 18,0 Monate, p=0,179). Die pathologische

Tumorregression nach Becker war signikant besser in der FLOT-Gruppe

(p=0.001). Die Subgruppenanalyse zeigte ein größeren erapievorteil für

Patienten mit AEG-Tumor und Nicht-Siegelringzellkarzinom.

Discussion: FLOT4 war auch in einer nicht selektierten Patientenkohorte

im Hinblick auf Gesamtüberleben und pathologisches Ansprechen eek-

tiver als der ehemalige erapiestandard aus 5-FU und Platinumderivat.

Interessanterweise protierten Patienten mit AEG-Tumoren mehr und

Patienten mit Siegelringzellkarzinom weniger von der erapie mit FLOT4.

Conclusion: Die Ergebnisse der vorliegenden Arbeit bestätigen die Daten

aus den prospektiven Phase II/III Studien.

Disclosure Statement: e authors declare the following: MG has contributed to

advisory boards for Roche, Eisai, BMS, MSD and AZ.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 67

351

Impact of viral aetiology in the Phase 3 HIMALAYA study

of tremelimumab (T) plus durvalumab (D) in unresectable

hepatocellular carcinoma (uHCC)

Stephen L Chan1; Masatoshi Kudo2; Bruno Sangro3; Katie Kelley4;

Junji Furuse5; Joong-Won Park6; Patrapim Sunpaweravong7;

Angelica Fasolo8; Thomas Yau9; Tomokazu Kawaoka10; Ann-LI Cheng11;

Sergio Azevedo12; María Reig13; Eric Assenat14; Mark Yarchoan15;

Aiwu R He16; Mallory Makowsky17; DI Ran17; Alejandra Negro17;

Thomas J. Ettrich18; Ghassan Abou-Alfa19,20,21

1State Key Laboratory of Translational Oncology, Department of Clinical

Oncology, Sir Yue-Kong Pao Center for Cancer, The Chinese University of Hong

Kong, Hong Kong, Hong Kong

2Department of Gastroenterology and Hepatology, Kindai University Faculty of

Medicine, Osaka, Japan

3Liver Unit and HPB Oncology Area, Clínica Universidad de Navarra and

CIBEREHD, Pamplona, Spanien

4Helen Diller Family Comprehensive Cancer Center, University of California, San

Francisco, USA

5Department of Gastroenterology, Kanagawa Cancer Center, Yokohama, Japan

6Department of Gastroenterology and Hepatology, Center for Liver and

Pancreatobiliary Cancer, National Cancer Center, Goyang, Republik Korea

7Department of Medicine, Prince of Songkla University Hospital, Songkhla,

Thailand

8Fondazione Michelangelo, Mailand, Italien

9Queen Mary Hospital, Pok Fu Lam, Hong Kong, Hong Kong

10Department of Gastroenterology and Metabolism, Hiroshima University,

Hiroshima, Japan

11National Taiwan University Cancer Center and National Taiwan University

Hospital, Taipei, Taiwan

12UPCO- Hospital de Clínicas de Porto Alegre, Porto Alegre, Brasilien

13Barcelona Clinic Liver Cancer (BCLC), Liver Unit, Hospital Clinic de Barcelona,

IDIBAPS, CIBEREHD, University of Barcelona, Barcelona, Spanien

14Department of Medical Oncology, Saint Eloi Hospital, Montpellier University,

Montpellier, Frankreich

15Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, USA

16Division of Hematology and Oncology, Lombardi Comprehensive Cancer

Center, Georgetown University, Washington, USA

17AstraZeneca, Gaithersburg, USA

18University Hospital Ulm, Comprehensive Cancer Center Ulm, Ulm,

Deutschland

19Department of Medicine, Memorial Sloan Kettering Cancer Center, New York,

USA

20Weill Medical College, Cornell University, New York, USA

21Trinity College Dublin, Dublin, Irland

Background: In HIMALAYA (NCT03298451), a single high priming

dose of T plus D (STRIDE) signicantly improved OS vs sorafenib (S),

and D was noninferior to S in uHCC (Abou-Alfa et al. NEJM Evid 2022).

Viral aetiology is associated with hepatic impairment in HCC develop-

ment and may inuence immunotherapy activity. We analysed the impact

of viral aetiology on clinical outcomes.

Methods: is exploratory analysis assessed STRIDE, D and S in pts

with HBV (presence of HBsAg and/or anti-HBcAb with detectable HBV

DNA), HCV or nonviral/other (NV) aetiology. OS HR were calculated

using a Cox proportional hazards model. As subsets were not sized for

formal comparisons, no multiplicity adjustments were made. A post hoc

multivariate analysis was used to identify chance imbalances in key prog-

nostic factors that may bias estimated treatment eects.

Result: Baseline demographic and disease characteristics were similar

across treatment arms in the HBV and NV subsets. In the HCV group,

multivariate analysis identied imbalances in two prognostic variables:

extrahepatic spread (EHS; more frequent for STRIDE than S) and ALBI

(score ≥2 more frequent for STRIDE and D than S). OS and PFS were

improved with STRIDE vs S in the HBV and NV groups, but not in the

HCV group. Using a stratied Cox proportional hazards model to account

for imbalances in EHS and ALBI in the HCV subset, OS HRs favoured

STRIDE vs S. OS HRs favoured STRIDE when adjusting for EHS and

ALBI in the other subgroups and in aetiological subgroups. Results for D

vs S showed similar trends.

Conclusion: In HIMALAYA, OS favoured STRIDE vs S across aetiolog-

ical subgroups when subsets were adjusted for prognostic factor imbal-

ances in the HCV cohort; similar trends were observed with D vs S across

subsets. ese results conrm the benets of STRIDE and D in pts with

uHCC, irrespective of underlying aetiology.

Funding: AstraZeneca

Previously presented at ESMO 2022, 714P: Impact of viral aetiology in the Phase3

HIMALAYA study of tremelimumab (T) plus durvalumab (D) in unresectable

hepatocellular carcinoma (uHCC), Stephen L Chan et al. - Reused with

permission.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

367

Phase 1b Results of Bemarituzumab

(BEMA)+mFOLFOX6+Nivolumab (NIVO) for Advanced Gastric/

Gastroesophageal Junction Cancer (G/GEJC): FORTITUDE-102

Part 1

Zev Wainberg1; Kensei Yamaguchi2; Jaer A. Ajani3; Jospeh Chao4;

Markus Möhler5; Yoon-Koo Kang6; Eric Van Cutsem7; Priscilla K. Yen8;

DI Zhou9; Telma Murias Dos Santos8; Kohei Shitara10

1University of California at Los Angeles, Department of Medicine, Division

ofHematology and Oncology, Los Angeles, USA

2Cancer Institute Hospital of Japanese Foundation for Cancer Research,

Department of Gastroenterological Chemotherapy, Tokyo, Japan

3The University of Texas MD Anderson Cancer Center, Department of

Gastrointestinal Medical Oncology, Division of Cancer Medicine, Houston, USA

4City of Hope Comprehensive Cancer Center, Duarte, USA

5Johannes-Gutenberg University Clinic, Department of Medicine, Mainz,

Deutschland

6University of Ulsan College of Medicine, Asan Medical Center, Department of

Oncology, Seoul, Republik Korea

7University Hospitals Gasthuisberg Leuven and KU Leuven, Department of

Gastroenterology/Digestive Oncology, Leuven, Belgien

8Amgen Inc, Thousand Oaks, USA

9Amgen Inc, San Francisco, USA

10National Cancer Center Hospital East, Department of Gastroenterology and

Gastrointestinal Oncology, Kashiwa, Japan

Background: In FORTITUDE-102 trial, part 1 (open-label phase [ph] 1b)

evaluated the safety and tolerability of BEMA+mFOLFOX6+NIVO and

part 2 (randomized ph3) the safety and ecacy versus placebo. Here, we

present the results of part 1.

Methods: Up to 20 pts with/without FGFR2b overexpression could be

enrolled. e initial dose of BEMA was 15 mg/kg IV Q2W with one 7.5

mg/kg dose on cycle 1 day 8. e dose-limiting toxicity (DLT) period was

28 days. At least 6 pts were treated at a dose level with less than 33% inci-

dence of DLTs to determine the recommended ph3 dose (RP3D). An ad

hoc review was performed 6 mo aer the DLT period.

Result: Eight enrolled pts (4 Asian and 4 White) were evaluated for DLTs:

age was 50-71 years, 6 pts were men. No DLTs were reported; no new

safety signals were identied. Mean exposures for the rst 3 cycles and

estimated terminal elimination half-life (7-11 days) were consistent with

historical data. No meaningful BEMA exposure changes were observed

with the addition of NIVO, indicating no drug interactions. e RP3D

was 15 mg/kg Q2W with one 7.5 mg/kg dose on cycle 1 day 8. Six mo

post-DLT period, the median treatment duration was 34 weeks (8-40).

Four pts had 6 serious AEs (1 hyponatremia considered BEMA-related);

7 pts had 13 grades ≥3 AEs (4 [neutropenia, mucositis, hyponatremia,

and delirium] in 2 pts considered BEMA-related). Five pts reported 8ocu-

lar AEs of grades ≤2 with a median time to onset of 17 weeks. No AEs

led to BEMA discontinuation. Treatment was interrupted in 4 pts due to

BEMA-related AEs (1 was ocular related). Partial response was seen in 3

pts, stable disease in 4 pts, and progressive disease (PD) in 1 pt. BEMA was

stopped for consent withdrawal in 1 pt and for PD in 2 pts.

Discussion: Updated data will be presented at the congress.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts68

Conclusion: is is the rst time a combination of BEMA, mFOLFOX6,

and NIVO is assessed. In part 1, consistent safety and pharmacokinetic

proles suggest no negative interaction, with no new safety signals aer

6 mo. In part 2, this combination is being studied in G/GEJC pts with

FGFR2b ≥10% tumor cells with moderate to strong membrane staining.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

370

Outcomes by baseline liver function in patients with

unresectable hepatocellular carcinoma treated with

tremelimumab and durvalumab in the Phase 3

HIMALAYA study

Arndt Vogel1,2; Stephen L Chan3; Junji Furuse4; Won Young Tak5;

Gianluca Masi6; Maria Varela7; Jee Hyun Kim8; Suebpong Tanasanvimon9;

María Reig10; Farshid Dayyani11; Mallory Makowsky12;

Michelle Marcovitz12; Alejandra Negro12; Ghassan Abou-Alfa13

1Medizinische Hochschule Hannover, Hannover, Deutschland

2Toronto General Hospital, Toronto, Canada

3Chinesische Universität Hongkong, Hong Kong, China

4Kyorin University School of Medicine, Mitaka, Japan

5Kyungpook National University School of Medicine, Daegu, Republik Korea

6Universität Pisa, Pisa, Italien

7Central University Hospital of Asturias, Oviedo, Spanien

8Seoul National University Bundang Hospital, Seongnam-si, Republik Korea

9Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand

10Universitat de Barcelona, Barcelona, Spanien

11University of California, Irvine, USA

12AstraZeneca, Gaithersburg, USA

13Memorial Sloan-Kettering Cancer Center, New York, USA

Background: In HIMALAYA (NCT03298451), a single, high priming

dose of tremelimumab+durvalumab (STRIDE) signicantly improved

overall survival (OS) vs sorafenib and durvalumab was noninferior to

sorafenib (Abou-Alfa et al. 2022) in uHCC. Liver function is frequently

impaired in HCC patients and it is important to evaluate ecacy and

safety of systemic therapies for these patients.

Methods: HIMALAYA included patients with Child-Pugh Score classA.

Baseline liver function was evaluated using albumin-bilirubin (ALBI)

score. Exploratory analyses assessed OS, objective response rate (ORR),

and safety in patients classied into ALBI grade 1 and ALBI grade 2/3

subgroups.

Results: Baseline characteristics in the subgroups were similar across

treatment arms. In ALBI grade 1 patients, mOS (95%CI) was 23.43

months (19.19-28.75) with STRIDE, 21.16 months (17.38-25.86) with

durvalumab, and 19.02 months (15.67-23.16) with sorafenib; 36-month

OS rates were 38.0%, 27.0%, and 27.3%, respectively.

ORRs were 21.7% for STRIDE, 18.7% for durvalumab, and 7.4% for

sorafenib. In ALBI grade 2/3 patients, mOS (95%CI) was 11.30 months

(9.33-14.19) with STRIDE, 12.29 months (9.30-16.03) with durvalumab,

and 9.72 months (7.23-11.76) with sorafenib; 36-month OS rates were

21.8%, 22.5%, and 12.9%, respectively. ORRs were 18.3% for STRIDE,

15.2% for durvalumab, and 2.7% for sorafenib. Safety in the ALBI sub-

groups was generally consistent with the full analysis set.

Discussions: -

Conclusions: STRIDE showed a favorable benet-risk prole compared

with sorafenib across ALBI subgroups. STRIDE and durvalumab may

represent new treatment options in uHCC for patients with less optimal

liver function.

Previously presented at ESMO WCGI 2022, FPN: O-5, Arndt Vogel etal. - Reused

with permission.

Funding: AstraZeneca

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

372

Impact of mutation status on ecacy outcomes in TOPAZ-1:

A Phase 3 study of durvalumab (D) or placebo (PBO) plus

gemcitabine and cisplatin (+GC) in advanced biliary tract

cancer (BTC)

Arndt Vogel1,2; Juan Valle3; Shukui Qin4; Lorenzo Antonuzzo5;

David Tougeron6; Choongkun Lee7; Benjamin Tan8; Masafumi Ikeda9;

Violeta Guthrie10; Patricia Mccoon11; Young Lee10; Nana Rokutanda10;

Magdalena Żotkiewicz12; Gordon Cohen10; Do-Youn Oh7

1Medizinische Hochschule Hannover, Hannover, Deutschland

2Toronto General Hospital, Toronto, Kanada

3Universität Manchester, Manchester, United Kingdom

4Bayi Hospital, Nan Jing Shi, China, VR

5Careggi University Hospital, Firenze, Italien

6Poitiers University Hospital, Poitiers, Frankreich

7Yonsei University College of Medicine, Seoul, Republik Korea

8Washington University School of Medicine, St. Louis, USA

9National Cancer Center Hospital East, Kashiwa, Japan

10AstraZeneca, Gaithersburg, USA

11AstraZeneca, Waltham, USA

12AstraZeneca, Warsaw, Polen

Background: In the double-blind, Phase 3 TOPAZ-1 study

(NCT03875235), overall survival (OS) with D+GC versus PBO+GC

was signicantly improved in patients (pts) with previously untreated

advanced BTC (Oh et al. NEJM Evid 2022; doi:10.1056/EVIDoa2200015).

An exploratory objective of the TOPAZ-1 study was to assess ecacy out-

comes by tumour mutations.

Methods: Eligible pts were randomised 1:1 to receive D+GC or PBO+GC.

Genomic proling of formalin-xed paran-embedded tumour tis-

sues from biomarker-evaluable pts (BEPs) was performed using the

FoundationOne® panel (Foundation Medicine, Cambridge, MA).

Mutation prevalence and outcomes based on the 25 February 2022 data

cut-o were descriptively assessed across subtype and geographical region

subgroups.

Result: BEPs comprised 441/685 pts (64% of full analysis set). TP53,

CDKN2A/CDKN2B/MTAP on chromosome 9p21, KRAS and ARID1A

were the most frequently altered genes. Mutation prevalence varied by

subtype, consistent with previous reports. OS hazard ratios (HR) with

D+GC versus PBO+GC for pts with mutant or wild-type genes that are

clinically actionable with prevalence greater than 3% are shown (IDH1

9%, ERBB2 amplication 8%, BRCA1/BRCA2 4%, BRAF 4%, FGFR2

rearrangement 3%). While prevalence is low for many of the alterations,

HRs<1 are noted for all clinically actionable mutant subtypes except

ERBB2 alterations. However, response rates were nominally higher in the

majority of D+GC vs PBO+GC groups, including ERBB2 alterations, sug-

gesting activity in these subgroups.

Discussion: -

Conclusion: BTC mutation prevalence in TOPAZ-1 by primary tumour

location and geographical region was consistent with other studies.

Although pt numbers were low and the condence intervals were broad,

pts with clinically actionable alterations (IDH1, BRAF and BRCA1/2

mutations and FGFR2 rearrangements) appeared to benet from D+GC.

Previously presented at ESMO Asia Congress, FPN 680, Juan Valle et al., - Reused

with permission.

Funding: AstraZeneca

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 69

375

Immune-mediated adverse event (imAE) incidence, timing

and association with ecacy in the Phase 3 TOPAZ-1 study

of durvalumab (D) or placebo (PBO) plus gemcitabine and

cisplatin (+ GC) in advanced biliary tract cancer (BTC)

Alexander-Otto König1; Lorenzo Antonuzzo2; Hidenori Takahashi3;

Joon Oh Park4; Aumkhae Sookprasert5; Roopinder Gillmore6; Shengshun

Yang7; Juan Cundom8; Mila Petrova9; Gina Vaccaro10; Marielle Holmblad11;

Julia Xiong12; Katrin Heider13; Nana Rokutanda11; Do-Youn Oh14

1Universitätsmedizin Göttingen, Göttingen, Deutschland

2Universität Florenz, Firenze, Italien

3Osaka International Cancer Institute, Osaka, Japan

4Universität Sungkyunkwan, Seoul, Republik Korea

5Khon Kaen University, Khon Kaen, Thailand

6Royal Free Hospital, London, United Kingdom

7Taichung Veterans General Hospital, Taichung, Taiwan

8Instituto de Investigaciones Metabólicas, Buenos Aires, Argentinien

9MHAT Nadezhda, Soa, Bulgarien

10Providence Cancer Institute, Portland, USA

11AstraZeneca, Gaithersburg, USA

12AstraZeneca, Waltham, USA

13AstraZeneca, Cambridge, United Kingdom

14Seoul National University College of Medicine, Seoul, Republik Korea

Background: In TOPAZ-1 (NCT03875235), D + GC signicantly

improved OS vs PBO + GC for patients (pts) with advanced BTC (Oh

D-Y, et al. J Clin Oncol 2022;40(suppl 4). Abs 378). D (immune checkpoint

inhibitor) may cause imAEs; imAEs have been associated with outcome

(Zhou X, et al. BMC Med 2020;18:87).

Methods: Safety was assessed in pts who received ≥1 dose of treatment:

D (1500 mg Q3W) or PBO, + G (1000 mg/m2) and C (25 mg/m2) on

days 1 and 8 Q3W, for up to 8 cycles, followed by D (1500 mg Q4W)

or PBO monotherapy until disease progression or unacceptable toxicity.

imAE (AEs of special/possible interest, linked to drug exposure, likely

immune-mediated mechanism, no clear alternate aetiology) incidences

were calculated by programmatic adjudication.HR and mOS were calcu-

lated using the Kaplan-Meier method. CI for mOS was derived based on

Brookmeyer-Crowley method.

Result: imAEs occurred in more pts in D + GC vs PBO + GC (12.7% vs

4.7%; 1 pt may have >1 imAE). Incidence of Grade 3/4 or serious imAEs

was low; median time to onset (mTTO) varied. e most common imAEs

(>1% of pts in one arm) were hypothyroid events (5.9% vs 1.5%), der-

matitis/rash (3.6% vs 0.3%), hepatic events (1.2% vs 0.6%) and adrenal

insuciency (1.2% vs 0.3%). imAEs in D + GC required concomitant

treatment more frequently than PBO + GC (systemic corticosteroids 8.0%

vs 3.5%, high dose steroids 3.8% vs 2.9%, endocrine therapy 6.5% vs 1.5%,

other immunosuppressant 0.3% vs 0.3%). imAEs were generally manage-

able and consistent with the known safety prole. In D + GC, mOS was

numerically greater in pts with an imAE of any grade (17.3 months; 95%

CI, 12.4–nc]) vs those without (12.6 months; 95% CI, 10.5–13.6; OS HR

0.62; 95% CI, 0.38–0.97).

Dicussion: -

Conclusion: Most imAEs were Grade 1/2 and manageable; imAEs did not

increase discontinuation. imAEs occurred at any time during/aer treat-

ment; mTTO varied depending on type. Although pt numbers are low,

imAEs may be associated with greater OS benet; further investigation

is warranted.

Previously presented at ESMO Congress, FPN 57P, Lorenzo Antonuzzo etal.,

reused with permission.

Funding: AstraZeneca

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

377

Four-year overall survival update from the phase 3

HIMALAYA study of tremelimumab (T) plus durvalumab (D) in

unresectable hepatocellular carcinoma (uHCC)

Bruno Sangro1; Stephen L Chan2; Katie Kelley3; George Lau4; Masatoshi

Kudo5; Wattana Sukeepaisarnjaroen6; Enrico De Toni7; Junji Furuse8;

Yoon-Koo Kang9; Peter R. Galle10; Lorenza Rimassa11,12; Alexandra

Heurgué13; Vincent C. Tam14; Tu Van Dao15; Satheesh Chiradoni

Thungappa16; Valeriy Breder17; Yuriy Ostapenko18; María Reig19; Mallory

Makowsky20; Charu Gupta21; Alejandra Negro20; Ghassan Abou-Alfa22,23,24

1Liver Unit and HPB Oncology Area, Clínica Universidad de Navarra and

CIBEREHD, Pamplona, Spanien

2State Key Laboratory of Translational Oncology, Department of Clinical

Oncology, Sir Yue-Kong Pao Center for Cancer, The Chinese University of Hong

Kong, Hong Kong, Hong Kong

3Helen Diller Family Comprehensive Cancer Center, University of California, San

Francisco, USA

4Humanity and Health Clinical Trial Center, Humanity and Health Medical Group,

Hong Kong, Hong Kong

5Department of Gastroenterology and Hepatology, Kindai University Faculty of

Medicine, Osaka, Japan

6Department of Medicine, Songklanagarind Hospital, Khon Kaen University,

Khon Kaen, Thailand

7Department of Medicine II, University Hospital, LMU Munich, München,

Deutschland

8Kanagawa Cancer Center, Yokohama, Japan

9Department of Oncology, University of Ulsan College of Medicine, Asan

Medical Center, Seoul, Republik Korea

10Department of Internal Medicine I, University Medical Center, Mainz,

Deutschland

11Department of Biomedical Sciences, Humanitas University, Mailand, Italien

12Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Mailand, Italien

13Department of Hepato-Gastroenterology, Robert-Debré Hospital, Reims,

Frankreich

14Tom Baker Cancer Centre, Department of Oncology, University of Calgary,

Calgary, Kanada

15Cancer Research and Clinical Trials Center, Department of Optimal Therapy,

National Cancer Hospital, Hanoi, Vietnam

16Health Care Global Enterprises Ltd, Bangalore, Indien

17N. N. Blokhin Russian Cancer Research Center, Chemotherapy Unit, Moskau,

Russische Föderation

18Department of Minimally Invasive and Endoscopic Surgery, Interventional

Radiology, National Cancer Institute, Kiev, Ukraine

19Barcelona Clinic Liver Cancer (BCLC), Liver Unit, Hospital Clinic de Barcelona,

IDIBAPS, CIBEREHD, University of Barcelona, Barcelona, Spanien

20AstraZeneca, Gaithersburg, USA

21Oncology Biometrics, Late Oncology Statistics, AstraZeneca, Wilmington, USA

22Memorial Sloan Kettering Cancer Center, Cornell University, New York, USA

23Weill Medical College, Cornell University, New York, USA

24Trinity College Dublin, Dublin, Irland

Purpose: In the primary analysis (DCO: 27-Aug 2021) of the HIMALAYA

study (NCT03298451) in uHCC, a single high priming dose of T plus D

(STRIDE) was superior to sorafenib (S), and D mono was noninferior to

S, for OS (Abou-Alfa et al. NEJM Evid 2022). Here, we report the 4-year

OS update.

Method: Pts with uHCC and no previous systemic treatment were ran-

domised to STRIDE (T 300 mg single dose, D 1500 mg Q4W), D mono

(1500 mg Q4W) or S (400 mg bid). Primary EP was OS for STRIDE vs S

(DCO for this analysis: 23-Jan 2023, 78% OS data maturity for STRIDE).

OS and sTRAEs were assessed. Baseline demographics and disease char-

acteristics were assessed in LTS (pts surviving ≥36 mo).

Results: 1171 pts were randomised to STRIDE (n=393), D (n=389) or

S (n=389); median (95% CI) duration of follow-up for OS analysis was

49.12 (46.95–50.17), 48.46 (46.82–49.81) and 47.31 (45.08–49.15) mo. e

OS HR (95% CI) for STRIDE vs S was 0.78 (0.67–0.92) and OS rates at 36

mo were for STRIDE 30.7% and for S 19.8%, which is consistent with pri-

mary results. e 48-mo OS rate was 25.2% for STRIDE and 15.1% forS.

sTRAEs (incl. death) occurred in 17.5% of pts treated with STRIDE and

9.6% treated with S; no new safety events were observed. D mono main-

tained non inferiority to S. Baseline demographics, clinical characteristics

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts70

and subsequent therapies, incl. pts rechallenged with T among the LTS

group in the STRIDE arm were consistent with FAS, suggesting that LTS

benet was not driven by any particular subgroup.

Conclusions: is updated analysis shows the sustained, long-term OS

benet of STRIDE vs S with unprecedented 3- and 4-year OS rates and

the longest follow-up to date in phase 3 studies in uHCC. e STRIDE

regimen maintained a tolerable yet dierentiated safety prole from other

uHCC therapies. ese results continue to support the benets of STRIDE

in a diverse global uHCC population.

Previously presented at ESMO World GI 2023, SO-15: 4-Year overall survival

update from the phase 3 HIMALAYA study of tremelimumab plus durvalumab

in unresectable hepatocellular carcinoma, Bruno Sangro etal. - Reused with

permission.

Funding: AstraZeneca

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

492

Real-world evidence in gastric and esophageal cancer: a

non-interventional study of rst-line (1L) nivolumab plus

chemotherapy or in combination with ipilimumab (the NIS

INGA study)

Alexander Stein1; Sylvie Lorenzen2; Jens Kisro3; Gertraud Stocker4;

Martin Herber5; Eyck von der Heyde6; Jens Uhlig7; Andreas Köhler8;

Henning Pelz9; Lothar Müller10; Stefan Kasper11; Florian Lordick4

1Hämatologisch-Onkologische Praxis Eppendorf Universitäres Cancer Center,

Hamburg, Deutschland

2Klinik und Poliklinik für Innere Medizin III, Klinikum rechts der Isar der TU

München, Munich, Deutschland

3Lübecker Onkologische Schwerpunktpraxis, Lübeck, Deutschland

4Medizinische Klinik II und Universitäres Krebszentrum Leipzig, Leipzig,

Deutschland

5Bristol Myers Squibb, Munich, Deutschland

6Onkologische Praxis am Raschplatz, Hannover, Deutschland

7Praxis Dr. Jens Uhlig, Naunhof, Deutschland

8Gemeinschaftspraxis für Hämatologie und Onkologie, Langen, Deutschland

9Onkologie Oenburg, Ambulantes Therapiezentrum für Hämatologie und

Onkologie, Oenburg, Deutschland

10Studienzentrum UnterEms, Leer, Deutschland

11Department of Medical Oncology, West German Cancer Center, University

Hospital Essen, Essen, Deutschland

Background: Nivolumab (NIVO) + chemotherapy (chemo) is approved

in the European Union (EU) for 1L treatment (Tx) of advanced gastric

cancer/gastroesophageal junction cancer/esophageal adenocarcinoma

(GC/GEJC/EAC) with programmed death ligand 1 (PD-L1) combined

positive score (CPS) ≥5. NIVO + chemo and NIVO + ipilimumab (IPI)

are approved in the EU for 1L Tx of advanced esophageal squamous cell

carcinoma (ESCC) with tumor cell (TC) PD-L1 ≥1%. However, as Tx

experience is primarily based on clinical trial data, real-world (RW) data

are urgently needed to validate the eectiveness, tolerability and qual-

ity of life (QoL) in a broader patient (pt) population. is prospective,

non-interventional, multicohort study will evaluate 1L NIVO + chemo

in advanced GC/GEJC/EAC and ESCC and 1L NIVO + IPI in advanced

ESCC in RW conditions in Germany.

Methods: Pts with previously untreated, HER2-negative, advanced or

metastatic GC/GEJC/EAC with PD-L1 CPS ≥5 who started Tx with NIVO

+ chemo (cohort [C] 1, n=350) and pts with previously untreated, unre-

sectable advanced, recurrent or metastatic ESCC with TC PD-L1 ≥1%

who started Tx with NIVO + chemo (C2, n=200) or NIVO + IPI (C3,

n=50) will be enrolled. Key exclusion criteria include concomitant or pre-

vious malignancy (≤3 years [y]) and current enrollment in an interven-

tional trial for GC/GEJC/EAC or ESCC. Pts will be followed for up to 3y

from enrollment. Assessments will be per routine local clinical practice.

Data will be collected on Tx initiation, then every 6 weeks until week 48,

then every 6 months until month 36. e primary endpoint is overall sur-

vival over 3y of follow-up. Secondary endpoints include ecacy, safety,

and pt-reported outcomes.

Results: Recruitment is ongoing in 79 centers in Germany. As of 21 July

2023, 100 pts are enrolled in C1. Of pts with available data, 79% are male

(n=95), mean age is 67y (range 45–88, n=95) and mean BMI is 25 kg/m2

(range 16–37, n=93). 88% of pts have ECOG PS of 0–1 (n=92) and

median of 2 metastases (range 0–9, n=21). Further baseline results will

be presented.

Discussion: Not available.

Conclusion: Not available.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

493

Multi-array miRNA approach and associated protein

expression proling for the development of predictive and

prognostic biomarkers in esophageal adenocarcinoma

Daniel Neureiter1; Christian Mayr2; Elen Neureiter1; Paul Winkelmann1;

Bettina Neumayer1; Eckhard Klieser1; Andrej Wagner3; Clemens Hufnagl4;

Klaus Emmanuel5; Josef Holzinger5; Oliver Koch5; Tobias Kiesslich2;

Martin Varga5

1Institute of Pathology, Paracelsus Medical University/University Hospital

Salzburg, Salzburg, Österreich

2Department of Internal Medicine I and Institute of Physiology and

Pathophysiology, Paracelsus Medical University/Salzburger Landeskliniken,

Salzburg, Österreich

3Department of Internal Medicine I, Paracelsus Medical University/Salzburger

Landeskliniken, Salzburg, Österreich

4Institute of Neurointervention, Department of Neurology, Paracelsus Medical

University/Salzburger Landeskliniken, Salzburg, Österreich

5Department of Surgery, Paracelsus Medical University/Salzburger

Landeskliniken, Salzburg, Österreich

Background: Esophageal adenocarcinoma (EA) may develop metastases

even in early stage (pT1) disease, but molecular biomarkers are lacking to

guide therapeutic decisions regarding surgical intensity (endoscopic/sur-

gical resection (ER/SR)). A multi-array miRNA study with consecutive in

silico analysis of dependent genes and in situ analysis of selected proteins

was chosen to detect possible biomarkers.

Methods: is retrospective analysis includes twenty cases of EA of the

distal esophagus/esophagocardial junction with ER without or SR with

lymph node metastasis (each n=10). e DNA of the FFPE material was

analysed using an advanced miRNA Human Card (spotted with 754

unique microRNAs) with consecutive in silico gene regulation and immu-

nohistochemical analysis of the associated proteins.

Result: e multi-array miRNA of the tumour sample with EA showed

an upregulation of 25 and a downregulation of 20 microRNAs, with the

highest dierences for the miRNAs miR-100-5p, miR-501-3p and miR-

576-5p (upregulation) and miR-150-3p, miR-190a-5p and miR-545-3p

(downregulation). e in silico analysis of these mirRNAs revealed the

downstream paired partners RDX-Rock2, DICER1-AGO2, YAF2-EZF6

and TET2-5HMC, which were signicantly dierentially expressed by

in-situ immunohistochemical staining.

Discussion: e molecular studies provide evidence for a specic miRNA

marker prole when comparing cases with localised and advanced EA. In

silico analysis revealed biologically relevant downstream gene and protein

targets, which were also signicantly dierentially expressed in-situ in

relation to the tumour stage of EA.

Conclusion: Taken together, these preclinical experimental biomarker

analyses may help to guide therapeutic decisions in cases with EA,

although validation in a larger cohort of EA is needed in the future.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 71

504

Prognostic implications of CRM-status in resected pancreatic

carcinoma – data obtained from the German cancer registry of

Baden-Württemberg

Jasmin Selina Schuhbaur1; Juliane Schütz1; Thomas Seuerlein1; Irina

Surovtsova2; Daria Kokh2; Gertrud Szotyori-Artz3; Claudia Winzler3;

Waldemar Uhl4; Andrea Tannapfel4; Philipp Morakis3

1Universitätsklinikum Ulm, Ulm, Deutschland

2Klinische Landeskrebsregisterstelle Baden-Württemberg, Stuttgart,

Deutschland

3Geschäftsstelle Qualitätskonferenzen bei der Klinischen Landesregisterstelle

Baden-Württemberg, Stuttgart, Deutschland

4Universitätsklinikum Bochum, Bochum, Deutschland

Background: Even if surgically resectable, pancreatic carcinoma still

accounts for one of the most unfavorable prognoses along malignancies. A

tumor-free resection margin (R0) bears prognostic meaning. However, in

pancreatic carcinoma dierent denitions of R0 exist. In order to explic-

itly dene the R0-status, the current German S3-guideline of pancreatic

carcinoma implemented the concept of circumferential resection margin

(CRM), which has long since been established for rectal carcinoma. While

the concept of CRM is plausible, current literature denes it heteroge-

neously and to date, there are few data documenting its prognostic mean-

ing in pancreatic carcinoma.

Methods: is analysis evaluates whether the CRM-status of resected

pancreatic carcinoma according to the current S3-guideline is in fact

prognostically relevant. erefore, patient data of the cancer registry of

Baden-Württemberg, Germany, have been analyzed including the years

of 2015 to 2020.

Result: We identied 1098 patients with resected pancreatic carcinoma

who met the inclusion criteria. We considered 340 patients R0 wide/CRM-

(distance of tumor cells from resection margin >1 mm), 410 patients R0

narrow/CRM+ (distance of tumor cells from resection margin ≤ 1 mm),

348 patients R1. R0 wide/CRM- status was associated with signicantly

increased 3-year-overall-survival in comparison to the other groups

(51,5%, 37,4% and 26,7% for R0 wide/CRM-, R0 narrow/CRM+ and R1,

respectively). Median progression free survival for R0 wide/CRM- was

prolonged in comparison to the other two groups as well.

Discussion: Even though it is not yet comprehensively well-established,

our data warrant for the routinely determination of CRM-status in

resected pancreatic carcinoma.

Conclusion: Our evaluation shows the prognostic importance of den-

ing the R-status according to the concept of CRM as implemented in the

German S3-guideline for pancreatic carcinoma.

Disclosure Statement: e authors declare no conict of interest.

517

Squamous esophageal carcinoma of the young female adult

Erik Wolniczak1; Christine March2; Roland Croner1; Daniel Medenwald3;

Frank Meyer1

1Dept. of General, Abdominal, Vascular and Transplant Surgery, University

Hospital, Magdeburg, Deutschland

2Dept. of Radiology and Nuclear Medicine, University Hospital, Magdeburg,

Deutschland

3Dept. of Radiation Therapy, University Hospital, Magdeburg, Deutschland

Background: Squamous esophageal carcinoma of the young adult can be

considered a rare tumor manifestation.

Aim: To illustrate the interesting and newsworthy case of a young female

patient with squamous esophageal cancer as a rare tumor manifestation

Methods: Scientic case report.

Result (case description):

Medical Hx:

- Current: Dysphagia

Diagnostic measures:

- Esophagogastroduodenoscopy: tumor lesion extending from 22 to 38

cm from row of teeth

- oracic/Abdominal CT scan

Decision-making (tumor board conference): Neoadjuvant radiochemo-

therapy (derived from CROSS protocol with 41.4 Gy and 5 cycles of che-

motherapy with Paclitaxel 50 mg/m² and Carboplatin AUC2 as well as

subsequent resection within the 6-weeks interval

Diagnosis: Squamous esophageal carcinoma (ypT3 pN0 M0 L0 V0 R0 G1)

of the middle and lower third (22-38 cm from row teeth)

Dierential diagnosis: Adeno-carcinoma of the esophagus, achalasia

Secondary diagnosis: - Mixed collagenosis

- Liver hemangiomas within the segment III and the right hepatic lobe

Surgical intervention: oracoabdominal esophagus resection with tho-

racic transposition of the stomach and esophagogastrostomy as well as

pyloromyotomy (in a dierent hospital)

Course: - Leukopenia (approximately 2.6 [SI]) during radiochemotherapy

- 3-yr-interval: Lobectomy of the right upper lobe

- Aer 5 yr: i.v.-port explantation due to infection with recurrent fever

attacks

Follow up: Adequate control investigations in a dierent hospital; cur-

rently, no hint for tumor recurrency

Conclusion: Despite the untypically young age, which does not exclude

completely the manifestation of a squamous esophageal carcinoma, the

same established treatment principles and modes are pursued (with

limited experiences due to the rare manifestation), which resulted in a

7-yr-survival.

Disclosure Statement: e authors declare no conict of interest.

550

The impact of inammation (chronic pancreatitis [Pan]) vs.

malignant tumor lesion (pancreatic head carcinoma [Ca])

including perioperative immune status on early postoperative

outcome in pylorus-preserving pancreatic head resection by

Traverso-Longmire (PPPHR)

Nikolas Scholz1; Max Grabowski1; Ronny Otto2; Roland Croner1;

Uwe Lodes3; Henry Ptok4; Frank Meyer1

1Dept. of General, Abdominal, Vascular and Transplant Surgery; University

Hospital, Magdeburg, Deutschland

2Otto-von-Guericke University, Institute of Quality Assurance in Operative

Medicine, Magdeburg, Deutschland

3Dept. of Anesthesiology and Intensive Care, Municipal Hospital (“AMEOS

Klinikum Schönebeck”), Schönebeck, Deutschland

4Dept. of General and Abdominal Surgery, Municipal Hospital

(“Ernst-von-Bergmann-Klinikum”), Potsdam, Deutschland

Background: Patients with chronic pancreatitis (Pan) & pancreas cancer

(Ca) undergo almost the same surgical intervention, namely, “pylorus-

preserving pancreatic head resection (PPPHR) by Traverso-Longmire”.

Objective: To determine the inuence of di. diagnoses (Pan vs. Ca, both

treated with PPPD) & periop. immune status on early postop. outcome

aer PPPHR over a dened observation period.

Methods: All consecutive patients (pats.) who had undergone PPPHR

for Ca or Pan over a 15-year period were included in a computer-based

data le as part of this systematic retrospective single-center observa-

tional study of surgical quality assurance. e early postop. outcome was

assessed by postop. morbidity (in detail with general/specic complica-

tion rate) & 30-d hospital mortality. Parameters included in the SOFA

score as well as C-reactive protein (CRP), leukocytes (L) & procalcitonin

(PCT) among others served as markers of immune response.

Result: From 10/01/2002-30/09/2017, a total of n=238 pats. were included

(Ca signicantly older & hospitalized longer). Rates of general & specic

complications w/ 21.6% (Ca) vs. 15.6% (Pan) & 39.7% (Ca) vs. 42.7%

(Pan; p=0.224/p=0.623) as well as 30-d mortality diered only by trend:

2.6%(Ca) vs. 2.1%(Pan; p=0.796).

CRP was signicantly elevated (Ca/Pan: 181.74/229.32 μg/l [d2]; p=0.026

& 180.69/240.65 μg/L [d3]; p=0.041) - d1 vs. d0 w/o signif. dierence

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts72

(81.65/88.01 μg/L), also found again in CRP increase (“d2-d1”: 92.8/131.7

μg/L; p=0.034 / “d2-d0”: not shown).

In addition, CRP increases were signicantly higher in early complica-

tions (yes/no: 122.69/83.1 μg/L; p=0.044 [d2-d1] & p=0.001 [d2-d0; data

not shown]).

Conclusion: Cancer disease does not appear to be a signif. factor in

the overall outcome despite older age & longer postop. hospital stay of

patients does not signicantly impact morbidity & mortality in standard-

ized pancreatic head resection. As a marker for the occurrence of early

complications, only CRP provided a signif. indicating correlation.

Disclosure Statement: e authors declare no conict of interest.

605

Radioactive Seed guidance for the resection of

cholangiocellular carcinoma in cirrhotic patients – a report

oftwo cases

Noa Aegerter1; Philipp Sedlaczek1; Georg Henninger1;

Gabriel Fridolin Hess1; Alexander Tzankov2; Simone Muenst2;

Noemi Schmidt2; Christoph J. Zech2; Otto Kollmar1; Savas Soysal1

1Clarunis, Basel, Schweiz

2University Hospital Basel, Basel, Schweiz

Background: Detection of cholangiocellular and hepatocellular carcino-

mas can be challenging in both radiologic imaging and during surgical

resection. erefore, radioactive seed-guided resection of these tumors,

analogously to breast cancer, could be an interesting approach.

Methods: We present two cases of cirrhotic patients where this method of

tumor labelling was used.

Result: e rst case was a suspected hepatocellular carcinoma in a patient

with alcoholic liver cirrhosis. Although the targeted lesions had been ver-

ied by intraoperative ultrasound before non-anatomical resection, his-

tological examination of the specimen showed no tumor. ree months

later, tumor progression was seen in a scheduled MR imaging of the liver.

erefore, in a two-step approach, the patient underwent interventional

labelling of the tumor with a radioactive seed followed by open resection.

Complete removal of a combined hepatocellular-cholangiocarcinoma of

the liver in segment VII could be histologically conrmed.

In the second patients, which presented nine months aer the rst one,

seed-guided resection was recommended due to probable cirrhosis, local-

ization and the small size of the two suspicious lesions. In this second

patient, the lesions were pre-labelled with help of TACE and Lipiodol the

day before. Subsequently, two radioactive seeds were placed in the lesions,

and resection was performed successfully. A cholangiocarcinoma within

the cirrhotic liver was diagnosed histologically.

Discussion/Conclusion: is report emphasizes the diculties, which

surgeons and radiologists may face in tumor entities that are dicult to

identify both macroscopically, by palpation and intraoperative imaging

techniques. It also highlights the successful adaption of a procedure com-

monly used for breast cancer surgery for liver surgery.

Disclosure Statement: e authors declare no conict of interest.

609

The impact of liver regeneration on tumor growth – A patient-

derived HCC organoid mouse model

Fabian Haak1; Gabriel Fridolin Hess1; Philipp Sedlaczek1; Caner Ercan2;

Salvatore Piscuoglio2; Mairene Coto-Llerena2; Savas Soysal1;

Otto Kollmar1

1Clarunis, Basel, Schweiz

2University Hospital Basel, Basel, Schweiz

Background: Recurrence is a signicant problem following treatment for

Hepatocellular Carcinoma (HCC). It aects more than 70% of patients

receiving a surgical resection. Recurrence can arise from undetected

micrometastasis (multicentric tumor) or “de novo” cancer. Clinical and

experimental studies suggest that liver regeneration ensuing surgical

resection may activate occult micro-metastasis leading to tumor recur-

rence. Here, we aim to establish an in vivo model to understand the

impact of liver regeneration on HCC tumor growth.

Methods: Patient Derived Organoids (PDOs) were generated from HCC

tissue. HCC-PDO organoids have been proved to retain the histopatho-

logical characteristic of the original tumor. Aer a laparotomy, HCC-PDO

were implanted in the liver of NOD Scid gamma mice. Experimental

group undergo a re-laparotomy and 30% or 70% hepatectomy while con-

trol group only receives a re-laparotomy. Tumor growth was monitored

by ultrasound until the end-point of the experiment. Healthy and tumor

tissue were characterized using immunohistochemistry.

Result: e HCC-PDOs implantation process has been rened and opti-

mized regarding scheme of anesthesia, volume and speed of injection.

We have successfully performed the implantation of 2 HCC-PDO lines.

Tumors obtained from the orthotopic models maintain the histopatho-

logical characteristic of the initial tumor. Preliminary results from animals

that received resections aer implantation, showed an increase in tumor

growth compared to control.

Discussion/Conclusion: Preliminary data shows an increased tumor

growth rate in our resection groups compared to control groups. Our

established orthotopic xenogra model can help understand the molecu-

lar basis of HCC recurrence aer surgery. erefore, this model may pro-

vide the basis for future projects for specic drug therapy before or aer

liver resection to inhibit tumor growth and favour regeneration.

Disclosure Statement: e authors declare no conict of interest.

612

Surgical Strategies for Hepatocellular Carcinoma in Cirrhotic

Patients: Anatomic versus Non-Anatomic Resection

Jasmin Zeindler1; Gabriel Fridolin Hess1; Maximilian von Heesen2; Philipp

Sedlaczek1; Noa Aegerter1; Cornelia Reber3; Andreas Michael Schmitt4;

Simone Muenst5; Martin Bolli1; Savas Soysal1; Otto Kollmar1

1Clarunis, Basel, Schweiz

2University Hospital Göttingen, Göttingen, Deutschland

3University of Basel, Basel, Schweiz

4The Royal Marsden NHS Foundation Trust, London, United Kingdom

5University Hospital Basel, Basel, Schweiz

Background: e incidence of hepatocellular carcinoma (HCC) is

increasing in the western world over the past decades. As liver resection

represents one of the most ecient treatment options, advantages of ana-

tomic (ALR) versus non-anatomic liver resection (NALR) show a lack of

consistent evidence. erefore, the aim of this study was to investigate

complications and survival rates aer both resection types.

Methods: is is a retrospective and prospective multicentre cohort study.

We included all patients undergoing liver resection for HCC between

2009 and 2020 from 3 specialised centres in Switzerland and Germany.

Complication and survival rates aer ALR versus NALR were analysed

using uni- and multivariate Cox regression models.

Result: 298 patients were included. 164/298 patients (55%) underwent

ALR. Signicantly more patients with cirrhosis received NALR (n =

94/134; p<0.001). Complications according to the Clavien Dindo classi-

cation were signicantly more frequent in the NALR group (p<0.001).

Liver failure occurred in 13% aer ALR versus 8% aer NALR (p<0.215).

Uni- and multivariate cox regression models showed no signicant dier-

ences between the groups for recurrence free survival and overall survival.

Furthermore, cirrhosis had no signicant impact on overall survival and

recurrence free survival.

Discussion/Conclusion: No signicant dierences on recurrence free

survival and overall survival rates could be observed. Postoperative com-

plications were signicantly less frequent in the ALR group while liver

specic complications were comparable between both groups. Subgroup

analysis showed no signicant inuence of cirrhosis on the postoperative

outcome of these patients.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 73

614

TACE Treatment Outcomes for Hepatocellular Carcinoma: A

Retrospective Cohort Analysis from a Swiss Tertiary Center

Fabian Haak1; Noa Aegerter1; Philipp Sedlaczek1; Tobias Karli2; Gabriel

Fridolin Hess1; Jasmin Zeindler1; Martin Takes3; Christoph J. Zech3;

Otto Kollmar1; Savas Soysal1

1Clarunis, Basel, Schweiz

2University of Basel, Basel, Schweiz

3University Hospital Basel, Basel, Schweiz

Background: International guidelines recommend transarterial chemo-

embolization (TACE) for intermediate-stage Hepatocellular carcinoma

(HCC). However, it is used outside these recommendations and has

proven to be benecial in prolonging survival. Since the role of TACE

outside BCLC stage B is unclear, the present study analyzed the results of

TACE performed at a tertiary center in Switzerland for dierent treatment

groups and aims to highlight the treatment outcomes in these groups.

Methods: is retrospective cohort study includes 101 HCC patients

undergoing TACE at our center. Tumor specications (size, localiza-

tion, number of lesions) and patient characteristics (scores for cirrho-

sis, Hepatoma arterial-embolization prognostic score) were included in

the analysis. Kaplan Meier survival curves were calculated for Barcelona

Center for Liver Cancer (BCLC) subgroups.

Result: Aer TACE median survival was 28.1 months for BCLC 0, 31.5

months for BCLC A, 20.5 months for BCLC B, 10.8 for for BCLC C and 7.5

months for BCLC D. Lesion size larger than 55mm was negatively associ-

ated with survival (HR 2.8, 95% CI 1.15 – 6.78). Complications occurred

aer TACE procedures: Clavien-Dindo I + II = 30. Clavien-Dindo ≥3 = 2.

Discussion/Conclusion: TACE was performed in a substantial part of our

cohort outside of routinely used treatment guidelines. e combination

of the survival data and complication rate in these patients suggest that

it was a safe and benecial strategy compared to systemic therapy or best

supportive care, which would be the suggested treatment according to the

guidelines. Furthermore, our data shows that in our cohort the survival

benet associated with TACE was restricted to the patients with a lesion

size smaller than 55mm.

Disclosure Statement: e authors declare no conict of interest.

621

Coincidence of three carcinomas (Ca) of the gastrointestinal

(GI) tract at dierent segments

Yelyzaveta Zaporozhchenko1; Christine March2; Robert Jänsch3;

Ulrich Vorwerk4; Daniel Medenwald5; Dörthe Jechorek6; Roland Croner1;

Frank Meyer1

1Dept. of General, Abdominal, Vascular and Transplant Surgery; University

Hospital, Magdeburg, Deutschland

2Dept. of Radiology and Nuclear Medicine, University Hospital, Magdeburg,

Deutschland

3Dept. of Gastroenterology, Hepatology and Infectious Diseases; University

Hospital, Magdeburg, Deutschland

4Dept. of Otorhinolaryngology, University Hospital, Magdeburg, Deutschland

5Dept. of Radiation Therapy, University Hospital, Magdeburg, Deutschland

6Institute of Pathology, University Hospital, Magdeburg, Deutschland

Background: Coincidence of neoplastic lesions can be considered an

extremely interesting subgroup of malignant tumor (Tu) patients.

Method: Scientic case report

Result (Case):

- Medical Hx: * 69-years old male patient w/ 1) colon Ca; 2) status aer

ESD of early gastric Ca (intestinal type at prepyloric site) pT1b(sm1)

L1V0Pn0R0G1; MMRp status; HER2/new status, negative; 3) status

aer squamous cell Ca of the le oropharynx cT4cN2bcM0 w/ pri-

mary radiochemoTx

- Clinical ndings: Patient in age-related general & nutritional status

- Diagnostic: * Lab parameters: CrP, 172 mg/L / white blood cell count,

within normal range

* Colonoscopy/Histology (Bx), adeno-Ca of the sigmoid colon,

70×42×14mm in size, lymphangiosis carcinomatosa

- Dx: 3 Ca of the GI tract with a recently diagnosed adeno-Ca of the

sigmoideo-rectal junction

- Decision-making: Indication for surgical intervention

- erapy: Anterior rectum resection w/ TME, lymphadenectomy &

descendorectostomy + protective loop ileostoma

- Histopathology: pT3pN1b(2/28)L1V0Pn0R0

- Postop. course: Intensive care for 24 h; on the 6th/12th postop. d: surgi-

cal re-intervention (anastomotic resection & new creation); thereaer,

improvement of clinical nding & lab parameters

- Complications: Anast. insuciency, wound seroma

- Proceeding: Antiseptic wound care (upper pole) in an outpatient clin-

ic-setting, stoma care, postop. chemotherapy (“CAPOX“) according to

Tu board conference’s recommendation, adequate follow up-investiga-

tions of the early gastric & oropharynx Ca

- Long-term outcome: Follow up-time periods of 45, 42 & 39 months,

resp., depending on Tu Dx showing recurrent Tu growth of orophar-

ynx Ca aer 40 months w/ subsequent radiation

Conclusion: From the extremely rare case example of a 3-fold Tu man-

ifestation with Ca’s at the same organ (GI tract), a substantial familiary

burden & a considerable individually increased risk constellation with

regard to epithelial &/or GI tract-associated tumorigenesis (also car-

cinogenesis) can be derived.

Disclosure Statement: e authors declare no conict of interest.

645

Identication of acquired chemoresistance mechanisms

in patient-derived organoid models of pancreatic

adenocarcinoma

Katharina Wansch1; Christopher Neumann1; Florian Dölvers1;

Sebastian Stintzing1; Ulrich Keilholz2; Uwe Pelzer1

1Charite Campus Mitte, Freie Universität Berlin, Humboldt Universität zu Berlin,

Berlin Institute of Health, Department of Hematology, Oncology and Cancer

Immunology, Berlin, Deutschland

2Charité Comprehensive Cancer Center, Charité Universitätsmedizin Berlin,

Berlin, Deutschland

Background: Pancreatic adenocarcinoma (PDAC) is one of the deadliest

types of cancers with 80% of patients relapsing within the rst ve years.

e poor prognosis results from limited treatment options and a high

level of resistance to chemotherapy.

To address these issues, patient-derived organoids (PDOs) have been eval-

uated as predictive plat-forms for treatment response in PDAC. Currently,

PDO drug response is measured at a single time point only. To gain a more

comprehensive understanding, we aim at developing a dynamic predictive

platform and insight into functional changes leading to chemotherapeutic

resistance.

Methods: We established PDOs of treatment-naïve patients and charac-

terized them histologically and genomically. Moreover, PDO response

to common chemotherapeutics was measured. Cultures were exposed

to six cycles of chemotherapy, closely mimicking the clinical situation

of patients, to induce resistance. Mechanisms of resistance are identi-

ed by analyzing the PDO transcriptome and proteome before and aer

chemotherapy.

Result: Pharmacotyping 10 PDO-cultures, a heterogeneous treat-

ment response was observed, representing intertumoral heterogeneity.

Moreover, we observed our models to become more chemoresistant aer

cyclic treatments. Induction of resistance was successful with models

showing a dierential response toward chemotherapy aer the treatment.

Discussion: Our results demonstrate that resistance induction in PDO

models is feasible. us, the predictive power of correlating in-vitro data

to clinical patient outcome will present a very promising tool for future

personalized medicine approaches.

Conclusion: e objective of our research project is the development of

a dynamic prediction platform for the iden-tication of chemotherapy

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts74

resistance in pancreatic adenocarcinoma. is dynamic predictive plat-

form may allow a deeper understanding of the tumor’s physiology, bet-

ter treatment choices and enhance the prognosis of these patients in the

long-term.

Disclosure Statement: e authors declare no conict of interest.

649

Investigation of dierential tumor physiology in

primary tumor and metastatic sites in pancreatic ductal

adenocarcinoma

Florian Dölvers1; Christopher Neumann1; Katharina Wansch1;

Sebastian Stintzing1; Ulrich Keilholz2; Uwe Pelzer1

1Charite Campus Mitte, Freie Universität Berlin, Humboldt Universität zu Berlin,

Berlin Institute of Health, Department of Hematology, Oncology and Cancer

Immunology, Berlin, Deutschland

2Charité Comprehensive Cancer Center, Charité Universitätsmedizin Berlin,

Berlin, Deutschland

Background: Pancreatic ductal adenocarcinoma (PDAC) is a major con-

tributor to cancer-related mortalities around the globe. It is estimated that

50% of patients are already in an advanced metastatic stage upon diagno-

sis. Unfortunately, the 5 year survival rate in the metastatic stage is 2%.

Based on the localization of metastases, dierent survival rates have been

clinically observed. Consequently, gaining a deeper comprehension of the

individual attributes of the primary tumor and its corresponding metasta-

ses is crucial in devising future personalized therapeutic strategies.

Methods: is project examines the dierential tumor physiology

between primary and synchronous metastases of PDAC using patient-

derived organoids (PDO). PDO models are being veried and charac-

terized immunohistochemically and genomically by the Cancer Hotspot

Panel. Drug sensitivities for known therapeutic regimens for PDAC are

being measured using the CellTiter-Glo® Luminescent Cell Viability Assay

and correlated to the CT-scans of patients using RECIST criteria. Further

multi-omics analyses are currently ongoing examining dierences in

transcriptome and proteome.

Result: PDO models from a total of four patients from the primary

and synchronous metastatic site have been established. Dierential

CDX2 expression in immunohistochemistry as well as dierent therapy

responses have been observed.

Discussion: Dierences in transcriptome and proteome could provide

targets to include dierential pharmacotypes for personalized treatment

in the future.

Conclusion: e results of this study could facilitate new therapeutic

approaches for metastatic PDAC in a personalized therapy approach.

Disclosure Statement: e authors declare no conict of interest.

653

Development of a High-Throughput Assay for Functionally

Proling Individual Tumors to Direct Clinical Decision Making

Sushmitha Sankarasubramanian1; Gerrit Erdmann2; Przemyslaw Dudys2;

Christian Pilarsky3; Christian Regenbrecht1,4,5; Christoph Reinhard1,4;

Lena Wedeken1

1CELLphenomics GmbH, Berlin, Deutschland

2NMI TT GmbH, Berlin, Deutschland

3Universitätsklinikum Erlangen, Erlangen, Deutschland

4ASC Oncology GmbH, Berlin, Deutschland

5Institute for Pathology, Universitätsklinikum Göttingen, Göttingen,

Deutschland

Background: Despite all scientic eort, pancreatic cancer remains a clin-

ically challenging disease. With systemic therapies oen being ineective,

more targeted treatment options are clinically needed. Response to these

therapies has high inter-patient variability, and there is currently a lack of

reliable biomarkers correctly predicting treatment outcomes.

Methods: We used patient-derived 3D pancreatic cancer models and

rened assay conditions to enable the high-throughput drug screening.

We combined this approach with DigiWest, a targeted proteomics tech-

nology, allowing for the assessment of basal protein expression levels and

pathway activities across dierent models. Integration of dierential pro-

tein expression levels with therapy sensitivity data was achieved through

robust functional pathway analysis.

Result: Our approach facilitates extensive high-content screenings,

involving an array of chemotherapeutic agents and targeted therapeutics.

Drug sensitivity proles were identied on individual basis. Employing

a comprehensive panel of over 233 (phospho-)antibodies, spanning the

MAPK/ERK/RAS, PI3K/AKT, and mTOR, cell cycle, proliferation, apop-

tosis, and DNA damage repair pathway on dierent models, we gained

insights into the functional aspects of these pathways in individual models.

Discussion: Combination of PD3D® models with DigiWest functional

pathway analysis is a potent toolkit for unraveling the molecular under-

pinnings of varied drug responses. is collaborative approach holds the

potential to deepen our insights into drug resistance and sensitivity, poten-

tially uncovering distinctive molecular markers with clinical relevance.

Conclusion: High-throughput drug screening using PD3D micro tumors

together with DigiWest analysis poses a robust instrument for decipher-

ing the intricate mechanisms dictating divergent responses to therapeutic

interventions.

Disclosure Statement: e authors declare the following: e authors declare the

following: CRAR is shareholder at CELLphenomics GmbH, a company oering

drug screens on organoid models, and ASC Oncology GmbH, a company involved

in patient specic therapy prediction.

690

Investigating patient-derived-organoids as a prediction

platform for clinical response in cholangiocarcinoma

A. Kühn*1, C.C.M. Neumann*1, K. Wansch1, F. Dölvers1, J. Ihlow2,

M.Dragomir2, S. Stintzing1, U. Keilholz3, U. Pelzer1

*both authors contributed equally

1Charite Campus Mitte, Freie Universität Berlin, Humboldt Universität zu Berlin,

Berlin Institute of Health, Department of Hematology, Oncology and Cancer

Immunology

2Department of Pathology, Charité-Universitätsmedizin Berlin, Freie Universität

Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Germany

3Charité Comprehensive Cancer Center, Charité Universitätsmedizin Berlin

Background: Cholangiocarcinoma (CCC) is an epithelial neoplasia of the

hepatobiliary system. 60-70% of patients are diagnosed at an advanced

stage and can only be oered a palliative therapy. ose patients, who are

eligible for surgical resection, are at 70% risk of recurrence within the rst

5 years. Recently, molecular targeted therapies have proven to be very

successful. However about 60% of patients do not show any targetable

mutations.

Methods: A total of 25 patient-derived organoids (PDOs) are being

isolated from metastatic or primary lesions of intrahepatic (iCCC) and

extrahepatic (eCCC) CCC. e models are characterized by histologi-

cal, immunohistochemical and genetic analyses. e PDOs will then be

pharmacotyped and classied based on their response using a statistical

or pharmacokinetic classication method. e in-vivo therapy response

of the donor patients will be evaluated radiologically and correlated to the

in-vitro classication of the corresponding PDOs.

Result: CCC PDOs were isolated from over 10 tumor samples, includ-

ing resection samples and tissue biopsies. We observed a success rate of

establishing cultures of at least 50%. Further PDO characterizations are

ongoing and models are being classied into resistant and sensitive.

Discussion: PDOs as prediction models have been poorly studied in CCC

research to date. Hogenson et al. recently correctly predicted the clinical

response of patients in one of two cases using two established CCC PDOs.

In 2021 Wang et al. also reported concordance between the response of an

eCCC as well as iCCC PDO with the clinical response of donor patients.

Yet, we propose a bigger and more comprehensive study including wild-

type PDOs and PDOs with IDH1/2- as well as FGFR2-alterations.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 75

Conclusion: is work aims at establishing PDOs for therapy prediction

in CCC patients and in their potential in precision medicine. Patients

without targetable mutations could particularly benet from such models

with future high-throughput drug-screening being implemented.

Disclosure Statement: e authors declare no conict of interest.

708

Outcomes by antibiotic use in participants with advanced

biliary tract cancer treated with durvalumab

Uwe Pelzer1; Aiwu R He2; Benjamin Tan3; Thatthan Suksombooncharoen4;

Hidenori Takahashi5; Ming-Huang Chen6; Vikas Ostwal7; Sang Cheul Oh8;

Emel Sezer9; Piotr Potemski10; Kun-Ming Rau11; Ekaphop Sirachainan12;

Junhe LI13; Jean-Frédéric Blanc14; Gordon Cohen15;

Magdalena Żotkiewicz16; Nana Rokutanda15; Do-Youn Oh17

1Charité-Universitätsmedizin Berlin, Division of Hematology, Oncology and

Tumor Immunology, Berlin, Deutschland

2Georgetown University, Division of Hematology and Oncology, Lombardi

Comprehensive Cancer Center, Washington DC, USA

3Washington University School of Medicine, Department of Medicine, St. Louis,

USA

4Chiang Mai University, Department of Internal Medicine, Faculty of Medicine,

Chiang Mai, Thailand

5Osaka International Cancer Institute, Department of Gastroenterological

Surgery, Osaka, Japan

6Taipei Veterans General Hospital, Department of Oncology, Taipei City, Taiwan

7Tata Memorial Hospital, Mumbai, Indien

8College of Medicine, Korea University, Division of Hematology and Oncology,

Department of Internal Medicine, Seoul, Republik Korea

9Mersin University Medical Faculty, Department of Oncology, Mersin, Türkei

10Medical University of Lodz, Copernicus Memorial Hospital, Department of

Cancer Chemotherapy, Lodz, Polen

11E-Da Cancer Hospital, Department of Hematology-Oncology, College of

Medicine, I-Shou University, Kaohsiung, Taiwan

12Ramathibodi Hospital, Mahidol University, Division of Medical Oncology,

Department of Medicine, Faculty of Medicine, Bangkok, Thailand

13The First Aliated Hospital of Nanchang University, Department of Oncology,

Nanchang, China, VR

14Hôpital Haut-Lévêque, Department of Hepato-gastroenterology and Digestive

Oncology, Bordeaux, Frankreich

15AstraZeneca, Oncology R&D, Late-Stage Development, Gaithersburg, USA

16AstraZeneca, Oncology Biometrics, Late Oncology Statistics, Warsaw, Polen

17Seoul National University Hospital, Cancer Research Institute, Seoul National

University College of Medicine, Division of Medical Oncology, Department of

Internal Medicine, Seoul, Republik Korea

Background: TOPAZ-1 is a double-blind, Phase 3 study of durvalumab

(D), an immune checkpoint inhibitor (ICI), + gemcitabine and cisplatin

(GC) in pts with advanced biliary tract cancer (BTC). D + GC improved

OS in pts with advanced BTC versus placebo (PBO) + GC (Oh et al. NEJM

Evid 2022). Use of antibiotics during ICI treatment has been correlated

with poorer OS and PFS (Jiang et al. Front Oncol 2022).

Methods: Pts were randomized 1:1 to receive D (1500 mg) or PBO on Day

1 every 3 weeks (Q3W), + G (1000 mg/m2) and C (25 mg/m2) on Days 1

and 8 Q3W, for ≤8 cycles, followed by D or PBO monotherapy Q4W. is

exploratory subgroup analysis assessed OS and PFS by systemic antibiotic

use during the study (≥1 dose 14 days before rst D/PBO dose to 14 days

aer last D/PBO dose). HRs were estimated using an unstratied Cox pro-

portional hazards model, adjusting for disease status (initially unresect-

able or recurrent) and primary tumor location. Data cut-o at primary

analysis was Aug 11, 2021.

Result: e number (%) of pts using antibiotics (D + GC, 167/341

[49.0%]; PBO + GC, 167/344 [48.5%]) was similar between both arms. In

the D + GC arm, median OS (95% CI) was similar regardless of antibiotics

use: 12.6 (9.7–14.8) months in pts with antibiotics use vs 13.0 (10.8–14.7)

months in pts without. In the PBO + GC arm, median OS (95% CI) was

10.3 (8.7–12.5) in pts with antibiotics use vs 12.1 (11.0–13.8) in pts with-

out. OS HRs (95% CI) in D + GC vs PBO + GC were 0.78 (0.59–1.02) in

pts with antibiotics and 0.81 (0.62–1.07) in pts without. Median PFS (95%

CI) was 7.3 (6.5–7.7) months in pts with antibiotics use vs 7.2 (5.9–7.4)

months in pts without in the D + GC arm and 5.7 (5.4–6.6) months vs

6.1 (5.6–7.3) months, respectively, in the PBO + GC arm (Table). PFS

HRs (95% CI) were 0.70 (0.55–0.89) in pts with antibiotics use and 0.82

(0.65–1.03) in pts without.

Conclusion: No meaningful dierence was found in OS or PFS for pts

who received antibiotics compared with those who did not. ese results

support that people receiving D may be treated with antibiotics when

indicated.

Clinical Trial identication: NCT03875235

Funding: AstraZeneca

Disclosure Statement: e authors declare the following: AstraZeneca Funding

765

Rare inammatory and neoplastic lesions of the appendix

vermiformis - spectrum and clinical courses

in a representative case series

Christoph Paasch1; Claus Schildberg1; Roland Croner2; Frank Meyer2

1Dept. of General and Abdominal Surgery, University Hospital, Brandenburg,

Deutschland

2Dept. of General, Abdominal, Vascular and Transplant Surgery, University

Hospital, Magdeburg, Deutschland

Background: In addition to the acute inammation of appendix vermi-

formis, there are numerous appendix-related dierential diagnoses, which

i) can occur in daily clinical practice, ii) can mimic acute appendicitis but

they are usually dierent w/ regard to its etiopathogenesis, clinical appear-

ance & therapeutic decision-making, & as well as iii) require adequate

diagnostic & therapeutic management.

Methods: Representative scientic case series (design) w/ rare appendix

vermiformis-associated manifestations of diverse diagnoses (AVAM) to

reect daily clinical, in particular, surgical practice.

Result (corner points):

- e spectrum of AVAM is broad - all specic diagnoses & entities can

mimic acute appendicitis w/ regard to clinical symptomatology, labo-

ratory parameter prole & (partially) imaging.

- AVAM are dominated by inammatory & neoplastic entities.

- Specic attention is focussed onto chronic appendicitis, appendicop-

athy, mucinous appendix carcinoma, acute appendicitis in a femoral

or inguinal hernia, twisted “appendix epiploica“, single metastasis of

gastric cancer at the appendix, appendagitis epiploica, subhepatic

appendicitis, perityphlitic inltration, neuroendocrinetumor lesion of

the appendix, pseudomyxoma peritonei in case of mucinous appendix

carcinoma.

- All determined entities required surgical intervention only in one

exceptional case, conservative therapeutic approach was imaginable in

denitive diagnosis-nding.

Conclusion: AVAM can have diverse origin and comprise various entities.

e competent, consequent, correct & early diagnosis-nding appears

decisive w/ regard to therapy, early postop. course & (in case of malignant

diseases) prognosis.

Histopathology & close interdisciplinary cooperation are - due to AVAM

rareness - a substantial prediction for a timely diagnosis-nding, prompt

therapeutic decision-making & practical realization as well as - if neces-

sary - subsequent therapeutic steps, possibly using variable modes.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts76

767

The clinical importance of the host anti-tumor reaction

patterns in regional tumor draining lymph nodes in patients

with locally advanced resectable gastric cancer: a systematic

review and meta-analysis

Elze Budginaite1; Maximilian Kloft1,2; Sander M.J. van Kuijk3; Pedro Canão4;

Kooreman Loes1; Pennings Alexander5; Derek R Magee6; Henry Woodru7;

Heike Grabsch1,8

1Department of Pathology, GROW School for Oncology and Reproduction,

Maastricht University Medical Center+, Maastricht, Niederlande

2Department of Internal Medicine, Justus-Liebig-University, Gießen,

Deutschland

3Department of Clinical Epidemiology and Medical Technology Assessment,

Maastricht University Medical Center+, Maastricht, Niederlande

4Anatomical Pathology Department, Centro Hospitalar Universitário de São

João, Porto, Portugal

5Department of Surgery, GROW School for Oncology and Reproduction,

Maastricht University Medical Center+, Maastricht, Niederlande

6School of Computing, University of Leeds, Leeds, United Kingdom

7The D-Lab: Decision Support for Precision Medicine, GROW School for

Oncology and Developmental Biology, Maastricht University Medical Center+,

Maastricht, Niederlande

8Pathology & Data Analytics, Leeds Institute of Medical Research at St James’s,

University of Leeds, Leeds, United Kingdom

Background: e status of regional tumor draining lymph nodes (LN) is

crucial for prognostic evaluation in gastric cancer (GC) patients1. Changes

in LN microarchitecture, such as follicular hyperplasia (FH), sinus histio-

cytosis (SH), or paracortical hyperplasia (PH), may be triggered by the

anti-tumor immune response2. However, the prognostic value of these

changes in GC patients is unclear.

Methods: A systematic search in multiple databases was conducted to

identify studies on the prognostic value of microarchitecture changes

in regional tumor-negative and tumor-positive LNs measured on histo-

pathological slides. Since the number of GC publications was very limited,

the search was subsequently expanded to include junctional and esopha-

geal cancer (EC).

Result: A total of 28 articles (17 GC, 11 EC) met the inclusion criteria,

analyzing 26,503 LNs from 3,711 GC and 1,912 EC patients. e stud-

ies described eight dierent types of LN microarchitecture changes,

categorized into three patterns: hyperplasia (SH, FH, PH), cell-specic

inltration (dendritic cells, T-cells, neutrophils, macrophages), and dier-

ential gene expression. Meta-analysis of ve GC studies showed a positive

association between SH in tumor-negative LNs and better 5-year overall

survival. Pooled risk ratios for all LNs showed increased 5-year overall

survival for presence of SH and PH.

Discussion: is systematic review suggests that SH and PH in regional

tumor-negative LNs may provide additional prognostic information for

gastric and esophageal cancer patients.

Conclusion: Further studies are needed to better understand LN reaction

patterns and explore the impact of chemotherapy treatment and immu-

notherapy ecacy.

References:

1 Smyth EC, Nilsson M, Grabsch HI, van Grieken NC, Lordick F. Gastric cancer.

Lancet. 2020 Aug 29;396(10251): 635–648.

2 Vollmer E, Krieg V, Shimamoto F, Grundmann E. Reaction patterns of lymph

nodes in the development and spread of cancer. Curr Top Pathol. 1991. 84

(Pt 2):1–34.

is research was funded by the Hanarth Fonds.

Disclosure Statement: e authors declare no conict of interest.

785

Clinical relevance of morphological heterogeneity

in pancreatic cancer

Aslihan Yavas; Lena Häberle; Irene Esposito

Institut für Pathologie, Universitätsklinikum Düsseldorf, Düsseldorf,

Deutschland

Background: Pancreatic ductal adenocarcinoma (PDAC) is a hetero-

geneous disease. However, the value of histomorphological subtyping

remains unknown. e aim of this study is to categorize PDACs according

to tumor morphology and investigate its relationship with clinicopatho-

logical ndings.

Methods: Using a detailed histomorphological analysis based on the

presence of a special histologic component in >30% of the tumor, 164

PDACs were classied as conventional, complex with small solid nests or

large solid sheets, papillary and cribriform. PDAC variants, presence of

clear cells (>30%) and pleomorphic single cells were assessed. One-way

ANOVA, Kruskal-Wallis, Mann-Whitney U tests and Kaplan-Meier sur-

vival curves were used for statistical analyses.

Result: PDAC variants accounted for 13% of the cases (8% adenosqua-

mous, 4% undierentiated, 1% micropapillary). While 35% of cases were

classied as conventional PDACs, 36% had complex, 14% papillary and

2% cribriform patterns. All complex PDACs were grade 3 (p<0.05) and a

higher proportion of them had pleomorphic single cells (61%) and clear

cells (27%) (p<0.05), compared to conventional and papillary tumors

Papillary PDACs revealed longer overall survival (median 30.2 months)

than conventional, complex and cribriform subtypes (median 19.3, 16 and

13 months, respectively), with signicant dierence between complex and

papillary PDACs (p<0.05).

Discussion: Our results conrm the highly heterogeneous nature of

PDAC and show prognostic relevance. PDACs with complex morphology

revealing cribriform structures, abortive glands, small solid nests or large

solid sheets, tend to be more aggressive and with higher WHO grades, as

opposed to conventional, papillary and pure cribriform PDACs.

Conclusion: Morphological classication is useful for better understand-

ing the characteristics of PDAC and predicting clinical outcome. Further

analyses are currently elucidating the association between molecular and

morphological subtypes of PDAC.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 77

854

Hep-Reg Trial An international retrospective/prospective

multicentre registry collecting data on patients treated with

SBRT for Hepatocellular CARCINOMA

Danny Jazmati1; Judit Boda-Heggemann2; Julien Merta3;

Ricarda von Krüchten4; Eleni Gkika5; Andrea Wittig-Sauerwein6;

Christiane Matuschek7; Wilfried Budach7; Oliver Blanck8; David Krug9;

Thomas Brunner10

1Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland

2Universitätsklinik Mannheim, Mannheim, Deutschland

3Westdeutsches Protonentherapiezentrum Essen (WPE), Essen, Deutschland

4Uniklinik Freiburg - Klinik für Radiologie - Schnittbildzentrum (SBZ), Freiburg

im Breisgau, Deutschland

5Universitätsklinikum Freiburg -Klinik für Strahlenheilkunde, Freiburg im

Breisgau, Deutschland

6Strahlentherapie - Uniklinikum Würzburg, Würzburg, Deutschland

7Strahlentherapie und Radioonkologie, Düsseldorf, Deutschland

8Universitätsklinikum Schleswig-Holstein, Campus Kiel, Klinik für

Strahlentherapie und Radioonkologie, Kiel, Deutschland

9Universitätsklinikum Schleswig-Holstein, Campus Kiel, Klinik für

Strahlentherapie und Radioonkologie, Kiel, Deutschland

10Universitätsklinikum Graz, Graz, Österreich

Purpose: Although stereotactic body radiotherapy (SBRT) is an eective

non-invasive therapeutic modality for inoperable hepatocellular carci-

noma (HCC), critical parameters such as optimal timing, dose, and target

volume selection within a multi-modality treatment context remain unde-

ned due to the limited sample size and heterogeneity in previous inves-

tigations. is retrospective and prospective registry study is designed to

collect clinical and therapeutic data from patients diagnosed with pri-

mary or locally recurring non-metastatic HCC who are undergoing or

have completed SBRT treatment. By creating a robust data repository, the

HepReg study registry aims to provide the foundation for future clinical

trials and the development of evidence-based treatment guidelines.

Methods: Both retrospective and prospective registry studies consider the

following inclusion criteria:

• Treatment of HCC with SBRT.

• Age ≥ 18 years.

• Informed consent of the patient, demonstrated by the existence of a

written consent form for data submission to the registry.

Results: e principal objective of the HepReg register is to compile a

comprehensive multicentre, multiplatform dataset, encompassing treat-

ment methodologies and patient outcomes. Specically, the focus is on

delineating the ecacy of local and intrahepatic control of irradiated

lesions, systemic disease control, overall survival, and progression pat-

terns. e study further strives to elucidate any correlations between

SBRT dose, administration and recurrence incidence. In addition, acute

and late eect data will be systematically recorded and analyzed.

Conclusions: e data collection process for both the retrospective and

prospective components of the study is slated to begin in October 2023.

e retrospective data collection is projected to conclude by October 2024,

while the prospective component, including an additional 24 months of

post-treatment data collection to record late toxicity and ecacy data, is

anticipated to nish by March 2027.

Disclosure Statement: e authors declare no conict of interest.

856

Perioperative or adjuvant nab-paclitaxel plus gemcitabine

for resectable pancreatic cancer: Quality of life results of the

randomized phase II AIO-NEONAX trial

Thomas J. Ettrich1; Sina Buchholz1; Waldemar Uhl2; Marko Kornmann3;

Hana Algül4; Helmut Friess5; Alexander-Otto König6; Michael Ghadimi7;

Eike Gallmeier8; Detlef K. Bartsch9; Manfred P. Lutz10; Ralf Metzger11;

Kai Wille12; Bertold Gerdes13; Carl C. Schimanski14; Florian Graupe15;

Volker Kunzmann16; Ingo Klein17; Michael Geissler18; Ludger Staib19;

Dirk Waldschmidt20; Christiane Bruns21; Uwe A. Wittel22;

Stefan Fichtner-Feigl22; Severin Daum23; Andreas Berger1;

Angelika Kestler1; Jasmin Schuhbaur1; Juliane Schütz1; Lukas Perkhofer1;

Anke Reinacher-Schick24; Thomas Seuerlein1

1Ulm University Hospital, Department of Internal Medicine I, Ulm, Deutschland

2Ruhr-University Bochum, St. Josef Hospital, Department of General and Visceral

Surgery, Bochum, Deutschland

3Ulm University Hospital, Department of General and Visceral Surgery, Ulm,

Deutschland

4TUM, CCC Munich-TUM and Department of Internal Medicine II, München,

Deutschland

5TUM, Department of General and Visceral Surgery, München, Deutschland

6University Medical Center Göttingen, Department of Gastroenterology,

Gastrointestinal Oncology, and Endocrinology, Göttingen, Deutschland

7University Medical Center Göttingen, Department of General and Visceral

Surgery, Göttingen, Deutschland

8University of Marburg, Department of Gastroenterology and Endocrinology,

Marburg, Deutschland

9University of Marburg, Department of General and Visceral Surgery, Marburg,

Deutschland

10Caritasklinik St. Theresia, Department of Gastroenterology, Saarbrücken,

Deutschland

11Caritasklinik St. Theresia, Department of General and Visceral Surgery,

Saarbrücken, Deutschland

12Ruhr University Bochum, Minden Department of Hematology and Oncology,

Minden, Deutschland

13Ruhr University Bochum, Department of General and Visceral Surgery Minden,

Minden, Deutschland

14Darmstadt Hospital, Department of Internal Medicine and Gastroenterology,

Darmstadt, Deutschland

15Darmstadt Hospital, Department of General and Visceral Surgery, Darmstadt,

Deutschland

16Julius Maximilians University Würzburg, Department of Internal Medicine II,

Würzburg, Deutschland

17Julius Maximilians University Würzburg, Department of General, Visceral,

Vascular and Pediatric Surgery, Würzburg, Deutschland

18Esslingen Hospital, Department of Hematology and Oncology, Esslingen am

Neckar, Deutschland

19Esslingen Hospital, Department of Surgery, Esslingen am Neckar, Deutschland

20University of Cologne, Department of Gastroenterology and Hepatology, Köln,

Deutschland

21University of Cologne, Department of Visceral Surgery, Köln, Deutschland

22University of Freiburg, Department of General and Visceral Surgery, Freiburg

im Breisgau, Deutschland

23Charite University Hospital Berlin, Department for Gastroenterology,

Rheumatology and Infectology, Berlin, Deutschland

24Ruhr University Bochum, Department of Hematology, Oncology and Palliative

Care, St. Josef-Hospital, Bochum, Deutschland

Background: Perioperative CTX in resectable PDAC is still not consid-

ered SoC and data regarding ecacy but also quality of life (QoL) are

limited. NEONAX is a randomized phase II trial in patients with rPDAC

examining perioperative (2 pre- and 4 postoperative cycles, arm A) or

adjuvant (6 cycles, arm B) of Gem/nab-P. DFS, OS and safety have already

been reported. Here we present the QoL data.

Methods: QoL was evaluated by EORTC QLQ-C30, QLQ-PAN26 and

HADS-D questionnaires: baseline, beginning of each CTX cycle, aer

neoadj. treatment in arm A as well as prior and post resection and aer 6

cycles of CTX.

Result: Global health status score (GHS-score) showed no dierence

between baseline (t1) and the timepoint aer 6 cycles of CTX (t2) in the

perioperative arm A (66.7/100 at both timepoints). Here patients expe-

rienced the lowest GHS-score pre- and postoperatively (50/100 in both

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts78

cases). Adjuvant arm B showed a deterioration in the GHS-score of 12.5

points from timepoint 1 to 2 (62.5/100 to 50.0/100). Here the lowest GHS-

score was observed within 4 weeks post-surgery (41.7/100). Physical

function score was decreased by 6.7 points (86.7/100 to 80/100) in periop-

erative arm A and by 26.7 points (86.7/100 to 60/100) in arm B between

both timepoints. Role function was reduced by 16.7 points (83.3/100 to

66.7/100) in arm A and by 33.3 points (83.3/100 to 50/100) in arm B

between both timepoints. In the remaining subscales of the used ques-

tionnaires the two arms of the trial showed comparable scores over the

whole study period.

Discussion: QoL was largely preserved in the perioperative as well as the

adjuvant arm of the NEONAX trial. GHS-score was lower pre-and postop-

eratively in arm A. e lowest GHS-score was observed postoperatively in

the adjuvant arm B. QoL was restored at the end of the treatment period in

the perioperative arm A and remained slightly reduced in arm B suggesting

that QoL is not substantially impaired by perioperative treatment in rPDAC.

Conclusion: e perioperative CTX scheme was shown to be an alterna-

tive to the standard adjuvant procedure in terms of quality of life

Disclosure Statement: e authors declare the following: Advisory Board,

Vortragshonorare: BMS

876

GSK3β;NFATc1 Subtype Specic Targeting in Pancreatic

Cancer

Aiko Bockelmann1; Umair Latif1; Kristina Reutlinger1; Sercan Mercan1;

Lukas Klein1; Karly Conrads2; Gabriela Salinas3; Marius Adler1;

Christoph Ammer-Herrmenau1; Holger Bastians4; Jovan Todorovic5;

Philipp Ströbel5; Elisabeth Heßmann1; Volker Ellenrieder1

1Department of Gastroenterology, Gastrointestinal Oncology and

Endocrinology, University Medical Center Göttingen, Göttingen, Deutschland

2Department of Medical Bioinformatics, University Medical Center Göttingen,

Göttingen, Deutschland

3Institute of Human Genetics, University Medical Center Göttingen, Göttingen,

Deutschland

4Institute of Molecular Oncology, Section for Cellular Oncology, Göttingen

Center for Molecular Biosciences (GZMB) and University Medical Center, Georg-

August University, Göttingen, Deutschland

5Institute of Pathology, University Medical Center Göttingen, Göttingen,

Deutschland

Background: Current studies demonstrate the existence of various molec-

ularly and genetically dened subtypes of pancreatic cancer, but their clin-

ical relevance and therapeutic potential are still unknown. An exception

are tumors with gBRCA1/2 mutation which are characterized by insu-

cient DNA damage repair (DDR) and are candidates for platinum-based

therapy and PARP inhibitor. e identication and characterization of

novel subtypes with addressable vulnerabilities are at the center of our

ongoing investigations.

Methods: Established models of murine and human PDAC cell lines,

patient-derived-cell lines (CDX) and -organoids (PDO) and human tissue

were used for our experiments. RNA-seq, qPCR, western-blot, ow-cy-

tometry, IHC, IF, live-cell imaging, homologous recombination (HR)

assay, BrdU and MTT studies were carried out.

Result: 16% of all human PDAC samples had high levels of GSK3β and

NFATc1 coincidently. e survival was signicantly worse in the GSK3βhigh

subgroup with sequentially high NFATc1 level. RNA-seq analyses identi-

ed GSK3β-NFATc1 regulated gene signatures involved in DDR and HR,

specically BRCA1, BRCA2, Rad51. Pharmacological or genetic inactiva-

tion of the GSK3β-NFATc1 pathway led to downregulation of DDR and

HR and HR assays showed a signicantly impaired HR. Genetic silenc-

ing of NFATc1 repressed DDR and increased basal and cisplatin-induced

DNA damage which persisted in recovery assays.

Discussion: Our studies revealed existence of a novel GSK3β;NFATc1high

subtype. Moreover, the subtype correlates with disease progression, resis-

tance, poor survival. Platin induced resistance causes increased expres-

sion and activation of the GSK3β-NFATc1 pathway, whereby NFATc1

highly regulates DDR. Finally, resistance in CDX and PDO is overcome

by targeting the GSK3β-NFATc1 pathway.

Conclusion: e GSK3β;NFATc1high subtype denes a highly aggressive

and resistant subgroup in pancreatic cancer. Moreover, targeted inacti-

vation of the GSK3β-NFATc1 pathway induces a “BRCAness phenotype”,

thus resensitizing PDAC to platin-based therapy.

Disclosure Statement: e authors declare no conict of interest.

910

Pancreatic cancer – progression prior diagnosis - a phenotypic

case collection

Paul Zedler1; Martin Fasshauer2; Silke Cameron1

1Department of Gastroenterology and General Internal Medicine, Klinikum

Hann. Münden, Hann. Münden, Deutschland

2Department of Radiology, Klinikum Hann. Münden, Hann. Münden,

Deutschland

Background: At primary diagnosis, pancreatic cancer (PC) generally is

advanced with poor prognosis. Early diagnosis is the clue to better sur-

vival rates as treatment options increase.

Methods: We retrospectively evaluated whether patients with diagno-

sis of PC (06/2017-06/2023) had a pre-diagnostic CT-scan. is CT was

re- evaluated for radiologic criteria indicative of PC, i.e. focal/distal atro-

phy of the pancreatic parenchyma, focal hypoattenuation, discontinuity/

enlargement of the pancreatic duct. Further, clinical complaints and risk

criteria were assessed.

Results: Pre-diagnostic CT-imaging was available in 12/ 56 patients

(21%). e mean age at diagnosis was 74 (48-91) years. 28/56 (50%)

complained of abdominal or back pain. 10/56 (17,8%) showed newly

developed icterus. 10/56 (17,8%) had pancreatitis at primary diagnosis,

4 with icterus/acholic stools. 8/56 (14,2%) had newly developed diabetes

and 13/56 (23,2%) a known diabetes. 18/56 (32,1%) complained about

B-symptoms, of those 15/56 (26,8%) reported weight loss. 10/56 (17,8%)

had documented thrombotic events: 4 patients with deep vein thrombo-

sis, 3 with lung embolia. 6/56 (10,7%) had a prior malign tumor.

Discussion: PC is not equivalent to painless icterus. Complaints are

non-specic. A conspicuity in the CT-scan – i.e. the incidental nding of

an ‘enlarged pancreatic duct without visible obstruction’ – should lead to

an appointment at the gastroenterologist. Similarly, pancreatitis of unclear

etiology should entail timely checkup.

Conclusion: In some of the cases, an early diagnosis would certainly have

led to a dierent outcome. It remains to be hoped that in the future, a

timely exchange of radiologist, primary physician and gastroenterologist

leads to an earlier diagnosis with better therapeutic options.

Disclosure Statement: e authors declare no conict of interest.

934

Activated-pancreatic stellate cells inuence the

chemoresistance and plasticity of pancreatic adenocarcinoma

through extracellular vesicles

Xiaolin Wu1; Jiahui LI1; Fei He2; Zhefang Wang1; Hinrich Hansen1;

Margarete Odenthal1; Jiangang Zhao1; Chenghui Zhou1; Dai LI1;

Felix Popp1; Roger Wahba1; Christiane Bruns1; Yue Zhao1

1Uniklinik Köln, Köln, Deutschland

2UNIVERSITÄT BONN, Bonn, Deutschland

Background: Pancreatic ductal adenocarcinoma (PDAC) is character-

ized by a high-aggression but insensitive chemotherapy reaction. It is

becoming clear that these features of PDAC benet from a complex tumor

microenvironment (TME) with intricate crosstalk between tumor and

stromal cells. Pancreatic stellate cell (PSCs) constitutes a main element

of TME, exhibiting both quiescent and activated states. Quiescent PSCs

could transform activated PSCs (aPSC) during tumorigenesis, which then

promotes cancer chemoresistance. Extracellular vehicles (EVs) play a

bridging role in the network of cancer biology. Our study aims to explore

the eect of EVs from aPSCs on chemoresistance and tumor plasticity in

PDAC.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 79

Methods: We isolated PSCs from PDAC-adjacent normal tissues and

checked the typical markers. PSCs were activated by the tumor condition

medium. EVs were isolated from PSCs and proved the quality. Tumor che-

moresistance, metastasis, and metabolism were detected in MTT assay,

Transwell invasion and seahorse XF assay respectively. Liquid chroma-

tography-mass spectrometry veried the biological function of EVs and

PDAC cells.

Results: PSC-EVs increased the survival of PDAC cell lines in gemcit-

abine treatment, enhanced invasion and metabolic-related Warburg

eect. Furthermore, the degree of PSC activity correlated with the eect of

PSC-EVs on tumor cells. Aer comparing the PDAC mass spectrometry

data before and aer the inuence of the PSC-EVs, we explored interest-

ing markers, including epithelial-mesenchymal transition (EMT) markers

(FN1), and metabolism markers. Grem1 exhibited the highest variation

and was associated with prognosis in pancreatic cancer patients in public

databases.

Discussion: Our data suggested a signicant role of PSCs-EV on che-

moresistance and metastasis of PDAC. Grem1 was carried by EVs and

involved in this tumor-mesenchymal crosstalk, which might also be

accompanied by EMT-like and metabolic changes.

Conclusion: e eect of EVs could be boosted due to the activation of

PSCs in the TME, which may explain mutualism between the PSCs and

PDAC.

Disclosure Statement: e authors declare no conict of interest.

Genitourinary Cancer including Prostate

Cancer

Quality of life and patient-relevant endpoints with

darolutamide in the phase 3 ARASENS study

Karim Fizazi1; Martin Bögemann2; Mathew Smith3; Maha Hussain4;

Fred Saad5; Cora N. Sternberg6; David Crawford7; Jeanny Aragon-Ching8;

Ateesha Mohamed9; Shankar Srinivasan9; Rui LI9; Iris Kuss10;

Heikki Joensuu11; Bertrand Tombal12

1Institute Gustave Roussy Chevilly-Larue, Chevilly-Larue, Frankreich

2Universitätsklinikum Münster, Münster, Deutschland

3Massachusetts General Hospital, Boston, USA

4Robert H. Lurie Comprehensive Cancer Center of Northwestern University,

Chicago, USA

5CHUM - Centre hospitalier de l’Université de Montréal, Montréal, Kanada

6Beverly Hills Institute for Precision Medicine, Los Angeles, USA

7UC San Diego School of Medicine, San Diego, USA

8Inova Laboratories - Schar Cancer Institute, Fairfax, USA

9Bayer HealthCare Pharmaceuticals Inc, Whippany, USA

10Bayer AG, Berlin, Deutschland

11Orion, Espoo, Finnland

12Cliniques universitaires Saint-Luc (UCLouvain), Bruxelles, Belgien

Background: In ARASENS, darolutamide (DARO) + androgen-depriva-

tion therapy (ADT) + docetaxel (DOC) signicantly reduced risk of death

by 32.5% vs placebo (PBO) + ADT + DOC in patients (pts) with meta-

static hormone-sensitive prostate cancer (mHSPC). Given the potentially

long treatment duration, the impact of DARO + ADT + DOC on pt-relevant

endpoints is important to assess.

Methods: Pts were randomized 1:1 to DARO 600 mg twice daily or PBO

+ ADT + DOC. Pt-relevant endpoints were all-cause and prostate cancer

related death; time course of adverse events (AEs) of special interest; and

quality of life (QoL) based on time to worsening (TTW) of disease-related

physical symptoms.

Results: In the safety analysis set (n=1302), the DARO + ADT + DOC

arm (n=652) had fewer all-cause deaths (35.1% vs 46.8%) and prostate

cancer related deaths (26.1% vs 36.0%) vs the PBO + ADT + DOC arm

(n=650). Despite longer treatment exposure with DARO vs PBO (median

41.0 vs 16.7 months), overall AE incidence was similar in both arms.

Fatigue (DARO 33.1%, PBO 32.9%) and rash (16.6%, 13.5%) appeared

predominantly in treatment months 1–3 and decreased rapidly thereaf-

ter. Cumulative incidences of falls, fractures, and mental impairment were

low (<10%) and similar between arms. e incidence of cardiac disorders

was constant over time and similar between arms (DARO 10.9%, PBO

11.7%). Incidence of hypertension was 13.7% vs 9.2%, with similar distri-

bution over time. Most pts had high baseline QoL scores that were main-

tained over time, with comparable TTW in both arms.

Conclusions: Early treatment intensication with DARO + ADT + DOC

improved pt-relevant endpoints, with reduced all-cause and prostate can-

cer related deaths and similar incidences and time course for most AEs of

special interest vs PBO + ADT + DOC, notably with no increase in car-

diac disorders. QoL was maintained over time, and DARO had no adverse

impact on QoL, including in pts with poor prognosis.

Reused with permission from the European Society of Medical Oncology (ESMO).

Previously presented by “First author name and family name” at ESMO 2022. All

rights reserved.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

First-line Axitinib plus Pembrolizumab in advanced renal cell

carcinoma: retrospective real world data from a multicentre

patient cohort

Christopher Darr1; Ramona Stelmach2; Katrin Schlack3; Hendrik Dinkel3;

Pia Paenholz4; Philipp Ivanyi5; Jonas Wiegmann5; Anton Schulz6;

Mario Kramer6; Marco Schnabel7; Emily Rinderknecht7; Analena Handke8;

Thomas Hilser9; Axel Heidenreich4; Boris Hadaschik1; Stefanie Zschäbitz2;

Viktor Grünwald1,9

1Department of Urology, University Hospital Essen and German Cancer

Consortium (DKTK), Essen, Deutschland

2Department of Medical Oncology, National Center for Tumor Diseases,

Heidelberg University Hospital, Heidelberg, Deutschland

3Department of Urology, University Hospital Muenster, Münster, Deutschland

4Department of Urology, Uro-Oncology, Robot Assisted and Reconstructive

Urologic Surgery, University of Cologne Faculty of Medicine and University

Hospital Cologne, Köln, Deutschland

5Department of Hematology, Hemostasis, Oncology, and Stem Cell

Transplantation, Claudia-von Lübeck, Deutschland

7Department of Urology, University Hospital of Regensburg, Regensburg,

Deutschland

8Department of Urology, Ruhr University Bochum, Marienhospital Herne, Herne,

Deutschland

9Department of Oncology, University Hospital Essen and German Cancer

Consortium (DKTK), Essen, Deutschland

Background: Axitinib plus pembrolizumab (AXI-PEM) is a standard of

care (SOC) in advanced renal cell carcinoma (aRCC) patients (pts). We

investigated real-world eectiveness in Germany.

Methods: We retrospectively evaluated tolerability and ecacy from pts

with metastatic (m)RCC who received rst-line treatment with axitinib

5 mg orally twice daily + pembrolizumab 200 or 400 mg i.v. at 8 cancer

centers in Germany between 2019-2023. Adverse events (AEs) were

reported according to CTCAE 5.0. Objective response rate (ORR) per

RECIST 1.1. Progression Free Survival (PFS) was calculated from start of

treatment to progression or death.

Results: 163 pts were included in the analysis with a median age of

65years (range: 58-72). 68% pts were male. Clear cell RCC was the dom-

inant histology in 71% (n=116). IMDC scores were: 0 in 35 (21.5%),

≥ 1 in 121 (74.2%), missing in 7 pts (4.3%). Nephrectomy was performed

in 63.8%, prior to a/mRCC. ECOG-PS was ≥2 in 12.8%. All grade AE

occurred in 91.4% of patients, with fatigue (38.7%), diarrhea (38.7%) and

hypertension (29.4%) as most common AEs. AEs grade ≥3 occurred in

49.7% of pts. In 53.3% dose reduction or interruption of either AXI or

PEM were performed, with dose reduction of AXI in 31.2%. AXI-PEM

was permanently discontinued due to toxicities in 19% of pts. ORR was

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts80

58.3%. Complete responses were 6.7%. Primary progression was 13.5%.

Median treatment duration was 8.0 months. Median PFS was 18 months

(95-CI; 11.6-24.4). Median OS was not reached, 14.1% (n=23) deaths

occurred with a median follow-up time of 24 months. Subsequent therapy

consisted of TKI monotherapy in 57 (34.9%) pts., favouring Cabozantinib

with 80.7%.

Conclusion: Our real-world cohort supports the use of AXI-PEM as a

rst-line standard in mRCC. No new safety signals were reported, but

dose reduction was frequently utilized. Major limitation is the retrospec-

tive data capture in our study.

Disclosure Statement: e authors declare the following: Honorar und

Beratungstätigkeit: Janssen-Cilag, IPSEN, Reisekosten: Janssen-Cilag, IPSEN

Ecacy and Safety of Darolutamide (DARO) in Combination

with Androgen-Deprivation Therapy (ADT) and Docetaxel

(DOC) by Disease Volume and Risk in the Phase 3 ARASENS

Study

Maha Hussain1; Martin Bögemann2; Bertrand Tombal3; Fred Saad4; Karim

Fizazi5; Cora N. Sternberg6; David Crawford7; Neal Shore8;

Evgeny Kopyltsov9; Arash Rezazadeh Kalebasty10; Dingwei Ye11;

Felipe Jose Cruz12; Hiroyoshi Suzuki13; Shankar Srinivasan14;

Frank Verholen15; Iris Kuss16; Heikki Joensuu17; Mathew Smith18

1Northwestern University Feinberg School of Medicine, Chicago, USA

2Westfälische Wilhelms-Universität-Münster, Münster, Deutschland

3Cliniques universitaires Saint-Luc (UCLouvain), Bruxelles, Belgien

4CHUM - Centre hospitalier de l’Université de Montréal, Montréal, Kanada

5Gustave Roussy, Villejuif, Frankreich

6Weill Cornell Graduate School of Medical Sciences, New York, USA

7UC San Diego School of Medicine, San Diego, USA

8Carolina Urologic Research Center, Myrtle Beach, USA

9Clinical Oncological Dispensary of Omsk Region, Omsk

10University of California, Irvine, USA

11Fudan Univ. Shanghai Cancer Center, Shanghai, China, VR

12Núcleo de Pesquisa e Ensino da Rede São Camilo, São Paulo, Brasilien

13Toho University Sakura Medical Center, Chiba, Japan

14Bayer Corporation, Whippany, USA

15Bayer Consumer Care AG, Basel, Schweiz

16Bayer AG, Berlin, Deutschland

17Orion Corporation, Espoo, Finnland

18Massachusetts General Hospital, Boston, USA

Background: In ARASENS (NCT02799602), DARO + ADT + DOC

signicantly reduced the risk of death vs placebo (PBO) + ADT + DOC

in patients (pts) with metastatic hormone-sensitive prostate cancer

(mHSPC), with similar incidences of treatment-emergent adverse events

(TEAEs). DARO improved overall survival (OS) across prespecied sub-

groups, including de novo and recurrent disease. For pts with mHSPC,

outcomes based on disease volume and risk provide additional informa-

tion to clinicians.

Methods: Pts with mHSPC were randomized 1:1 to DARO 600 mg twice

daily or PBO, with ADT + DOC. High-volume disease was dened as vis-

ceral metastases and/or ≥4 bone metastases with ≥1 beyond the vertebral

column/pelvis (CHAARTED criteria). High-risk disease was dened as

≥2 risk factors: Gleason score ≥8, ≥3 bone lesions, and presence of mea-

surable visceral metastasis (LATITUDE criteria). OS for these subgroups

was assessed using an unstratied Cox regression model.

Results: Of 1305 pts assessed, 1005 (77%) had high-volume disease, 912

(70%) had high-risk disease, 300 (23%) had low-volume disease, and 393

(30%) had low-risk disease. DARO + ADT + DOC prolonged OS regard-

less of high- or low-volume disease with HRs of 0.69 and 0.68 vs PBO +

DOC + ADT, respectively. OS benet of DARO vs PBO was similar for pts

with high- or low-risk disease. DARO improved clinically relevant sec-

ondary endpoints vs PBO in high/low-volume and risk subgroups. TEAE

incidences were consistent with the overall ARASENS population across

subgroups by high/low volume and high/low risk.

Conclusions: In pts with mHSPC, the benets of early treatment intensi-

cation with DARO + ADT + DOC on OS and key pt-relevant secondary

ecacy endpoints vs PBO + ADT + DOC were similar in patients with

high- and low-volume as well as high- and low-risk mHSPC. e favor-

able safety prole of DARO was conrmed in all volume/risk populations.

DARO + ADT + DOC is one of the new standards of care for pts with

mHSPC.

Disclosure Statement: e authors declare that there are conicts of interest.

econicts were submitted to the congress organizer KUKM GmbH and KUKM

can disclose them if needed.

Dosing, safety, and pharmacokinetics (PK) of combination

therapy with darolutamide (DARO), androgen-deprivation

therapy (ADT), and docetaxel (DOC) in patients with

metastatic hormone-sensitive prostate cancer (mHSPC) in the

ARASENS study

Arash Rezazadeh Kalebasty1; Peter Hammerer2; Bertrand Tombal3;

Maha Hussain4; Fred Saad5; Karim Fizazi6; Cora N. Sternberg7;

David Crawford8; Weijiang Zhang9; Bart Ploeger10; Rui LI9; Iris Kuss10;

Carsten Zieschang10; Sabine Wittemer-Rump10; Mathew Smith11

1University of California, Irvine, USA

2Städtisches Klinikum Braunschweig, Braunschweig, Deutschland

3Cliniques universitaires Saint-Luc (UCLouvain), Bruxelles, Belgien

4Northwestern University Feinberg School of Medicine, Chicago, USA

5CHUM - Centre hospitalier de l’Université de Montréal, Montréal, Kanada

6Gustave Roussy, Villejuif, Frankreich

7Weill Cornell Graduate School of Medical Sciences, New York, USA

8UC San Diego School of Medicine, San Diego, USA

9Bayer Corporation, Whippany, USA

10Bayer AG, Berlin, Deutschland

11Massachusetts General Hospital, Boston, USA

Background: In ARASENS (NCT02799602), DARO + ADT + DOC sig-

nicantly reduced risk of death vs placebo (PBO), with similar incidences

of treatment-emergent adverse events (TEAEs). We report dosing, safety

and PK of coadministration of DARO and DOC with ADT.

Methods: Patients with mHSPC were randomized 1:1 to DARO 600 mg

twice daily or PBO + ADT + DOC (75 mg/m2 q21d for 6 cycles). e eect

of DARO on DOC PK was assessed by noncompartmental analysis from

the rst 25 patients (pts) with dense PK data and by population PK for all

patients. DARO PK from ARASENS were compared with PK data from

ARAMIS (NCT02200614; without DOC) to evaluate the impact of DOC

on DARO PK.

Results: Of 1306 randomized pts, 1305 were included in the full anal-

ysis set (DARO, n=651; PBO, n=654). e median treatment duration

was longer with DARO vs PBO (41.0 vs 16.7 months) and more DARO-

treated pts (45.9% vs 19.1%) were still receiving treatment at primary

analysis cuto (Oct 25, 2021). Almost all pts completed 6 cycles of DOC

in both groups. e proportion of patients requiring DOC dose modi-

cation was similar between groups (DARO, 60.0%; PBO, 62.9%). TEAEs

led to discontinuation/reduction of DOC in 8.0%/19.9% of DARO pts and

10.3%/19.5% of PBO pts. A slight numeric increase (15% in Cmax) in

DOC exposure was observed in the DARO + DOC + ADT arm. is small

numeric increase is likely not clinically relevant given the variability in

DOC exposure (coecient of variation, 23%–54%). PK meta-analysis of

ARASENS and ARAMIS, which considered pts’ intrinsic characteristics

as covariates indicated a 10% lower AUC0-12ss of DARO in pts receiv-

ing DOC vs those not receiving DOC, which is not considered clinically

relevant.

Conclusions: DARO + DOC + ADT increased overall survival with simi-

lar incidences of TEAEs and no observed drug-drug interactions between

DARO and DOC. DARO can be eectively and safely administered with

DOC in pts with mHSPC without clinically relevant changes in PK of

DARO or DOC.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 81

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

Comparative real-world (RW) evidence on darolutamide

(Daro), enzalutamide (Enza), and apalutamide (Apa) for

patients (Pts) with nonmetastatic castration-resistant prostate

cancer (nmCRPC) in the United States: DEAR

Alicia Morgans1; Eva Hellmis2; Neal Shore3; Nasreen Khan4;

Niculae Constantinovici5; Javeed Khan6; Guifang Chen7; Julie Xu7;

Daniel George8

1Dana-Farber Cancer Institute, Boston, USA

2Urologicum Duisburg, Duisburg, Deutschland

3Carolina Urologic Research Center, Myrtle Beach, USA

4Bayer HealthCare, Whippany, USA

5Bayer Consumer Care AG, Basel, Schweiz

6Bayer plc, Reading, United Kingdom

7Bayer, Mississauga, Kanada

8Duke Cancer Institute, Durham, USA

Background: Novel androgen receptor inhibitors (ARIs) are recom-

mended for pts with nmCRPC. Daro has a distinct structure with low

blood-brain barrier penetration which may lead to a lower risk of cen-

tral nervous system-related adverse events (AEs) and minimal risk of

AEs commonly associated with ARIs. DEAR is the rst study compar-

ing RW utilization, outcomes, and AEs between daro and enza/apa in

nmCRPC pts.

Methods: is retrospective chart review cohort study used electronic

medical records from the PPS network of US urology practices. Eligible

pts had nmCRPC, no prior novel hormonal therapy, and initiated rst

ARI treatment (tx; index date) between 8/2019-3/2022. We describe the

% of pts who discontinued initial ARI tx (DISC), % who progressed to

metastasis (PROG), and % with AEs. A comparative analysis was done

between daro and enza/apa using Cox proportional hazards models for

time to DISC/time to PROG, adjusting for observed baseline (BL) factors.

Results: 870 pts were included (daro/enza/apa, n=362/382/126). Median

age (80/79/80 y), median BL prostate-specic antigen (PSA) doubling

time (6.8/6.4/7.4 mo), other BL characteristics, and median follow-up

were similar for daro/enza/apa. A lower % of pts had a DISC event on

daro vs enza/apa (30.4 vs 40.8/46.0) or a PROG event (17.7 vs 28.3/27.8)

during the study. Multivariate analyses adjusting for BL factors showed

that pts on daro had a lower risk of DISC and PROG over time vs enza/

apa. A lower % of pts on daro had AEs vs enza/apa (24.9 vs 29.3/30.2).

Conclusions: A lower % of pts discontinued initial ARI tx, progressed to

metastasis, or had AEs on daro vs enza/apa. When adjusting for observed

BL factors, pts on daro had considerably lower risk of DISC and PROG vs

enza/apa. is study conrms daro’s strong ecacy and favorable tolera-

bility prole in a RW setting. e longer tx duration seen with daro may be

American Society of Clinical Oncology, Inc. Reused with permission.

is abstract was accepted and previously presented at the 2023 ASCO Annual

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

Gender-specic overall survival of patients with invasive

urothelial carcinoma and other subtypes from the largest EU

cancer registry in North Rhine-Westphalia, Germany

Niklas Schürger1; Christopher Darr1; Lennart Möller2; Hiltraud Kajüter2;

Boris Hadaschik1; Henning Reis3,4; Thomas Hilser5; Aykhan Isgandarov1;

Andreas Stang2; Viktor Grünwald1,5

1Institut für Urologie, Universitätsklinikum Essen, Essen, Deutschland

2Landeskrebsregister NRW, Bochum, Deutschland

3Institut für Pathologie, Universitätsklinikum Frankfurt, Frankfurt, Deutschland

4Institut für Pathologie, Universitätsklinikum Essen, Essen, Deutschland

5Westdeutsches Tumorzentrum, Universitätsklinikum Essen, Essen, Deutschland

Background: Invasive urothelial carcinoma (UC) occurs predominantly

in men. Dierences in stage with putative prognostic relevance are antici-

pated. We analyzed the survival of men and women in terms of histologi-

cal subtypes, localization and T-stage.

Methods: Patients diagnosed with urinary tract neoplasms (ICD-

10: C65-C68) in the NRW registry database from 2008 to 2019 were

included. Non-UC were classied as squamous cell carcinoma (SCC),

pure adenocarcinoma (ADC), pure neuroendocrine cancer (NEC),

papillary urothelial carcinoma (PUC) and unspecied variants (Other).

5-year-survival was analyzed with Kaplan-Meier method. DCO-cases are

Death-Certicate-Only.

Result: A total of 61,043 patients were studied (73% men (M) and 27%

women (W). DCO-Cases (4,620: 11.3% for M and 6.1% for W) were

excluded. Histological proportion in men was 57% UC, 29% PUC, 3%

non-UC, 11% Other and in women 60% UC, 22% PUC, 7% non-UC, 11%

Other. Distribution in T-stage M (37% T1, 26% T2, 12% T3, 5% T4, 20%

T-unknown) and W (28% T1, 29% T2, 17% T3, 6% T4, 19% T-unknown).

Overall 5-year-survival in men was 45% and in women 40%. Survival in

subtypes for men were 62% Other, 54% PUC, 38% UC, 35% ADC, 27%

SCC, 17% NEC and for women 56% Other and PUC, 33% UC, 32% ADC,

26% SCC, 22% NEC. Survival for men and women were 37% and 38% for

Upper Tract Urinary Carcinoma (C65, C66), 44% and 40% for bladder

(C67) and 50% and 36% for miscellaneous (C68). In T1 survival was 59%

for men and women. Further survival: T2 (33% M, 29% W), T3 (28% M,

30% W), T4 (14% M, 11% W) and T-unknown (52% M, 48% W).

Discussion: Previous studies have shown that women have poorer sur-

vival than men. is was explained by advanced tumors, which this study

conrmed. A higher proportion of men had T1 tumors, which were asso-

ciated with better prognosis. Our study did not reveal major gender dier-

ences according to subtypes.

Conclusion: Women with invasive UC had poorer 5-year OS than men.

However, this was not the case for non-UC subtypes, as even NEC per-

formed better in women. Localization did not aect survival in women,

whereas UTUC performed worse than bladder in men.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts82

100

Real World Evidence from a retrospective multi-center

Analysis for Ipilimumab and Nivolumab (I/N) as rst-line

treatment in patients with advanced Renal Cell Carcinoma in

dierent IMDC risk categories

Katrin Schlack1,2; Linus Materna1; Ramona Stelmach3; Stefanie Zschäbitz4;

Stephanie Neuberger5; Can Aydogdu6; Jozena Casuscelli6; Timo Egenolf7;

Matteo Silberg8; Julie Steinestel9; A. Strauß10; Florian Kirchho11; Marit

Ahrens2,12; Pia Paenholz13; Richard Cathomas14; Christopher Gossler15;

Philipp Ivanyi2,16; Marc Rehlinghaus17; Thomas Hilser18; Viktor Grünwald2,18

1Department of Urology, University Hospital Münster, Münster, Deutschland

2Interdisciplinary Working Group Kidney Tumors (IAG-N) of the German Cancer

Society, Berlin, Deutschland

3Department of Medical Oncology, National Center for Tumor Diseases,

Heidelberg University Hospital, Heidelberg, Deutschland

4Department of Medical Oncology, National Center for Tumor Diseases,

Heidelberg University Hospital, Heidelberg, Deutschland

5Department of Urology and Pediatric Urology, University Medical Center of

Johannes Gutenberg University, Mainz, Deutschland

6Department of Urology, University Hospital, Ludwig Maximilian University of

Munich, München, Deutschland

7Department of Urology and Pediatric Urology, University Hospital Würzburg,

Würzburg, Deutschland

8Department of Urology, Marienhospital Herne, Ruhr University Bochum, Herne,

Deutschland

9Department of Urology, University Hospital Augsburg, Augsburg, Deutschland

10Department of Urology, University Medicine Göttingen, Göttingen,

Deutschland

11Department of Urology, Rechts der Isar Medical Center, Technical University

München, München, Deutschland

12Department of Oncology, University Hospital Frankfurt, Frankfurt,

Deutschland

13Department of Urology, University Hospital Köln, Köln, Deutschland

14Division of Oncology/Hematology, Kantonspital Graubünden, Chur, Schweiz

15Department of Urology, Krankenhaus St. Josef, University of Regensburg,

Regensburg, Deutschland

16Department of Hematology, Hemostasis, Oncology, and Stem Cell

Transplantation, Claudia-von Schelling Comprehensive Cancer Center,

Hannover Medical School, Hannover, Deutschland

17Department of Urology, University Hospital Düsseldorf, Düsseldorf,

Deutschland

18Department of Urology, University of Duisburg-Essen and German Cancer

Consortium (DKTK)-University Hospital Essen, Essen, Deutschland

Background: I/N were approved in 2018 (CheckMate214) as rst-line

therapy for patients with advanced renal cell carcinoma (aRCC) and

IMDC intermediate or poor risk. We retrospectively evaluated ecacy

and safety in a real-world cohort.

Methods: Patients initiating I/N from 2015 to 2023 were included. We

analyzed baseline demographics, clinical characteristics, and adverse

events (AEs) descriptively. Objective response rate (ORR) was analyzed

according to local standard. Progression-free (PFS) and overall survival

(OS) were estimated using Kaplan-Meier Analyses.

Result: We included 332 patients. Median age was 63 years (IQR 54-71).

ECOG PS ≥ 2 occurred in 12.9%. IMDC risk was intermediate in 64.5%

and poor in 26.8%. 17,2% of patients did not meet the inclusion criteria

for CheckMate214 (high ECOG, comorbidities, brain metastases, auto-

immune disease, impaired renal function). Median FU was 14.5 months

(IQR 6-29). 55.1% of patients received 4 cycles of I/N. 17.8% are still on

treatment. AEs occurred in 74.4% of patients (32.2% ≥ grade 3). Toxicity

led to discontinuation of I in 25.3% and N in 13.6% of cases. Most fre-

quently observed were fatigue (22.3%), elevated liver enzymes (18.1%),

thyroiditis (16.9%), pruritus (16.9%), rash (16.6%), and diarrhea (13.9%).

Corticosteroids were used in 35.5%, high-dose (≥ 40 mg/d prednisone)

steroids accounted for 26.5% of all cases. ORR was seen in 35.8% (CR

8.7%, PR 27.1%) of patients (38.3% intermediate, 32.6% poor risk).

Median PFS was 8 months (95%CI 6.1-9.9), OS 50 months (95%CI 37.9-

62.1). Patients at intermediate risk had a PFS of 9 (95%CI 6.1-11.9) and

an OS of 50 (95%CI 37.4-62.6) months compared to poor risk patients

with 4 (95%CI 1.6-6.4) and 19 (95%CI 11.4-26.6) months, respectively.

Subsequent therapy was administered in 190 cases (57.2%), most fre-

quently given was Cabozantinib (34%).

Discussion: Patient selection was less restrictive in our clinical practice

and may explain dierences to existing data.

Conclusion: Our real-world data support the use of I/N as rst-line treat-

ment option in aRCC with safe and robust eects.

Disclosure Statement: e authors declare the following: Advisory and lectureship

fees: AAA, Amgen, Apogepha, Astellas, AstraZeneca, Bayer, BMS, Eisai, EUSA

Pharma, Fosanis, Ipsen, Janssen-Cilag, Merck, MSD, Novartis, Pzer, and Roche;

Travel expenses Amgen, AstraZeneca, Bayer, Ipsen, Sano, Janssen-Cilag, Merck,

and Pzer

116

Palliative cytoreductivenephrectomy in the era of immune

combinations

Anne Mausbach1; Konstantin Seitzer2; Christopher Darr1; Thomas Hilser3;

Linda Huberth2; Martin Bögemann2; Andres Jan Schrader2; Martin

Janssen2; Barbara Heitplatz4; Laura Maria Krabbe5; Boris Hadaschik1;

Katrin Schlack2; Viktor Grünwald6

1Department of Urology, University Hospital Essen, Essen, Deutschland

2Department of Urology and pediatric Urology, University Hospital Münster,

Münster, Deutschland

3Clinic for Internal Medicine (Tumor research), University Hospital Essen, Essen,

Deutschland

4Gerhard-Domagk-Institute of Pathology, University Hospital Münster, Münster,

Deutschland

5Department of Urology, Vivantes Humboldt Hospital Berlin, Berlin,

Deutschland

6Department of Medical Oncology, West German Cancer Center, University

Hospital Essen, Essen, Deutschland

Background: Today, target systemic therapy are standard in the 1st line

treatment of advanced/metastatic renal cell carcinoma (RCC). Although

initial nephrectomy has long been an important treatment pillar, its value

has declined recently. is study evaluated the current relevance of initial

nephrectomy in advanced stage of RCC.

Methods: We included 56 patients with advanced RCC from university

hospital Essen and Münster starting 1st line systemic therapy between

03/18 to 01/23, of which 56% had a clear cell type. We assigned patients

into two cohorts, either cytoreductive surgery followed by systemic

therapy (cohort 1; 30 patients) or vice versa (cohort 2; 26 patients). ey

received either combinations of TKI and IO (77%) or anti-VEGF-TKI

monotherapy (23%). We investigated progression-free survival (PFS;

measured with Kaplan-Meier-method from start of systemic therapy

or nephrectomy to progression or death) and objective response rate

(ORR) according to RECIST1.1. Result: e age of the patients ranged

from 43 to 80 years with a median of 63 years, 64% had intermediate

and 36% had poor IMDC-risks. Median follow-up-time was 48 months.

Median PFS of 7 vs. 20 months showed a longer progression-free time in

cohort 2 (95% CI 5,7-16; p 0.02). e 36-months PFS was 6.7% (cohort

1) and 19.2% (cohort 2), respectively. In cohort 1, there were 32.7% with

progressive disease (PD), in cohort 2, 3.6%. ORR is 33% (cohort 1) vs.

84% (cohort 2). In cohort 1, 26.7% had to discontinue therapy due to

toxicity, in cohort 2, 16%.

Discussion: e sequence of systemic therapy followed by nephrectomy

was associated with a signicant PFS advantage. Nephrectomy followed

by systemic therapy was associated with a higher primary progression and

discontinuation rate. Major limitation is the retrospective nature of our

analysis and the clinical selection process, which may introduce bias to

our analysis.

Conclusion: e sequence of therapy followed by nephrectomy in

advanced RCC was associated with noticeably better outcomes than the

reverse sequence. Our observation warrants prospective studies.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 83

181

Split-dose cisplatin (C) + gemcitabine (G) use and associated

clinical outcomes in the rst-line (1L) treatment (tx) of locally

advanced or metastatic urothelial cancer (la/mUC): results of a

retrospective observational study in Germany (CONVINCE)

Katrin Schlack1; Thomas W. Kubin2; Markus Ruhnke3; Clemens Schulte4;

Stefan Machtens5; Anna Eisen6; Ulrike Osowski7; Silke Günther8;

Mairead Kearney8; Rainer Lipp6; Stephan Schmitz9

1Department of Urology, University Hospital Muenster, Muenster, Deutschland

2Department für Hematology, Oncology and Palliative Care, Clinics

Südostbayern AG, Clinic Traunstein, Traunstein, Deutschland

3Clinic for Hematology, Oncology and Palliative Medicine, Helios Clinic Aue,

Aue, Deutschland

4Practice for Hematology and Oncology, Dortmund, Deutschland

5Department of Urology, GFO Hospitals Rhein-Berg, Marien-Hospital, Bergisch-

Gladbach, Deutschland

6GermanOncology GmbH, Hamburg, Deutschland

7Merck Healthcare Germany GmbH, an aliate of Merck KGaA, Weiterstadt,

Deutschland

8Merck Healthcare KGaA, Darmstadt, Deutschland

9Medical Care Center for Oncology and Hematology, Cologne, Deutschland

Background: Platinum-based chemotherapy (PBC) followed by ave-

lumab 1L maintenance in patients (pts) without progressive disease is the

standard 1L tx for la/mUC. In pts ineligible for standard-dose C (1 day

per cycle), carboplatin (Cb) or split-dose C (35 mg/m2 on days 1 + 8) are

alternative options. e eectiveness of these regimens vs standard-dose

C has not been extensively examined. In this real-world (rw) study, we

compared clinical outcomes in pts with la/mUC who received 1L split-

dose C + G (CG-S) vs standard-dose C + G (CG) or Cb + G (CbG).

Methods: CONVINCE (initiated in Dec 2021) enrolled 188 pts who

received 1L tx in 2019-2020 in 27 oncology or urology institutions in

Germany. Objective response rate (ORR), rw progression-free survival

(rwPFS) and overall survival (rwOS) were compared between CG-S vs CG

and CG-S vs CbG groups. rwOS and rwPFS were estimated by Kaplan-

Meier analysis.

Results: 124/188 (66.0%) enrolled pts received 1L PBC + G: 27 (21.8%)

received CG-S, 75 (60.5%) CG, and 22 (17.7%) CbG. Median age was

66, 69, and 73 years, respectively. Most pts were male (CG-S, 70.4%, CG,

73.3%, CbG, 77.2%) and had an ECOG PS of 0/1 at diagnosis (CG-S,

59%/37%, CG, 55%/40%, CbG, 46%/50%). Median follow-up was 16.5

months. Median no. of cycles was 5, 4, and 6, respectively. In 116/124

evaluable pts, ORR with CG-S, CG, and CbG was 64.0%, 49.3%, and

59.1%, respectively (p=0.84 for CG-S vs CG; p=0.65 for CG-S vs CbG).

In the overall population (n=124), median rwPFS was 10.5, 10.5, and 9.1

months, respectively (p=0.35 for CG-S vs CG; p=0.24 for CG-S vs CbG).

Median rwOS was 14.4, 18.8, and 16.7 months, respectively (p=0.06 for

CG-S vs CG; p=0.14 for CG-S vs CbG).

Discussion: Despite its small sample size, this rw study provides valuable

insights into the use of 1L CG-S in routine clinical practice in Germany.

Conclusions: CG-S showed broadly comparable outcomes vs CG or CbG.

is analysis suggests that CG-S can be a viable alternative for pts with la/

mUC unsuitable for CG, without compromising tx eectiveness.

Previously presented at ESMO 2023, “FPN: 2388P”, “Katrin Schlack et al.” -

Reused with permission.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

265

Treatment duration and long-term safety and tolerability of

darolutamide in nonmetastatic castration-resistant prostate

cancer (nmCRPC): ARAMIS Rollover Study

Neal Shore1; Martin Bögemann2; Murilo Luz3; Albertas Ulys4;

Shankar Srinivasan5; Etah Kurland5; Karim Fizazi6

1Carolina Urologic Research Center, Myrtle Beach, USA

2Westfälische Wilhelms-Universität-Münster, Münster, Deutschland

3Erasto Gaertner Hospital, Curitiba, Brasilien

4Universität Vilnius, Vilnius, Lithuania

5Bayer HealthCare, Whippany, USA

6Gustave Roussy, Villejuif, Frankreich

Introduction: We report the long-term safety and tolerability of darolut-

amide (DARO) in the ARAMIS Rollover Study (ROS; NCT04464226).

Methods: In ARAMIS, 954 patients (pts) received double-blind (DB)

DARO 600 mg orally twice daily, of whom 591 pts continued on open-

label (OL) DARO following the primary analysis. On completion of

ARAMIS, 294 pts with no evidence of metastases and benetting clini-

cally from DARO entered the ROS. DARO treatment duration and safety

are described for the 954 pts over the DB, DB+OL, and DB+OL+ROS

periods.

Results: At data cut-o of Jan 31, 2022, median (range) duration of

DARO treatment was DB 1.5 years (0.0–4.0), DB+OL 2.1 years (0.0–4.9),

and DB+OL+ROS 2.8 years (0.0–6.8). Of the 954 randomized pts, 32.3%

received DARO treatment for ≥2–<4 years, 17.3% for ≥4–<5 years, and

12.8% for ≥5 years. As expected, cumulative incidences of treatment-emer-

gent adverse events (TEAEs) increased slightly with longer observation

time. For the DB, DB+OL, and DB+OL+ROS periods, respectively, TEAE

incidences were: any grade 85.7%, 89.8%, 91.5%; grade 3/4 26.3%, 31.8%,

35.5%; serious 26.1%, 32.1%, 38.5%; and leading to treatment discontin-

uation 8.9%, 10.5%, 12.9%. Increases in incidences of TEAEs commonly

associated with androgen receptor inhibition across the DB, DB+OL, and

DB+OL+ROS periods were mostly minimal. During the rst 24 months

of DARO treatment, incidences of most of these TEAEs were low and

≤2% dierent vs placebo, except for fatigue. Onset of these TEAEs by

time intervals across all study phases (DB, DB+OL, DB+OL+ROS) will

be presented.

Conclusions: Approximately 30% of pts with nmCRPC remained on

DARO for ≥4 years, suggesting long-term clinical benet. Most adverse

events occurred in the rst 2 years of treatment, with small increments

over time. e favorable safety prole of DARO was maintained with

long-term exposure. No new safety concerns were observed in the ROS.

Disclosure Statement: e authors declare that there are conicts of interest.

econicts were submitted to the congress organizer KUKM GmbH and KUKM

can disclose them if needed.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts84

276

Factors associated with not receiving systemic anticancer

treatment (tx) in patients (pts) with metastatic urothelial

carcinoma (mUC): results of a retrospective observational

study in Germany

Günter Niegisch1; Mairead Kearney2; Julia Krieger3; Ulrike Osowski4;

Carina Weinhold4; Barthold Deiters5; Ulf Maywald6; Silke Günther2;

Thomas Wilke7; Marc-Oliver Grimm8

1University Hospital and Medical Faculty of the Heinrich-Heine University,

Düsseldorf, Deutschland

2Merck Healthcare KGaA, Darmstadt, Deutschland

3Cytel, Berlin, Deutschland

4Merck Healthcare Germany GmbH, an aliate of Merck KGaA, Weiterstadt,

Deutschland

5GWQ ServicePlus AG, Düsseldorf, Deutschland

6Drug Department, AOK PLUS, Dresden, Deutschland

7IPAM eV, Wismar, Deutschland

8Universitätsklinikum Jena, Jena, Deutschland

Background: Real-world studies show that many pts with mUC do not

receive systemic tx. With the expanding therapeutic landscape for mUC,

identifying factors associated with undertreatment to mitigate outcome

disparities is essential.

Methods: is study identied adults with an incident mUC diagnosis

(dx; ICD-10 codes C65-68 + C77-79) in 2015-19 using 2 German statu-

tory health insurance (SHI) claims databases (2013-20, ≈8 mil. insured).

Baseline (BL) characteristics within 24 mo before dx were analyzed. Aer

dx, pts were followed for ≥12 mo or until death. Overall survival (OS) was

estimated by Kaplan-Meier analysis. Variables associated with receiving

systemic tx were identied using multivariable logistic regression.

Results: Overall, 3,226 pts (mean age, 73.8 y; male, 70.8%; mean Charlson

Comorbidity Index [CCI] score, 6.3) were identied. Mean follow-up was

13.8 mo. 1,892 pts (58.6%) did not receive systemic tx within 12 mo of

mUC dx. Median OS aer dx was notably shorter in untreated vs treated

pts: 3.0 vs 13.7 mo in SHI 1 and 3.6 vs 13.8 mo in SHI 2, respectively.

Untreated pts were signicantly older vs treated pts (≥80 y: 48.2% vs

13.5%); had considerably more comorbidities (mean CCI: 6.8 vs 5.5); and

had a higher care level (37.5% vs 11.0%). Factors associated with a higher

likelihood (odds ratio [95% CI]) of not receiving tx included older age

(at index, continuous; 0.93 [0.92-0.94]; p<0.001), no prior UC-related

surgery/tx (24-mo BL; 1.65 [1.37-2.00]; p<0.001), earlier dx in the study

period (reference, 2015; 1.11 [1.05-1.17]; p<0.001), CCI (24-mo BL, con-

tinuous; 0.97 [0.93-1.00]; p=0.011), and outpatient diagnosis setting (1.28

[1.05-1.54]; p=0.013).

Discussion: Low tx rate and shorter OS in untreated vs treated pts are

consistent with prior studies.

Conclusion: Identied factors associated with undertreatment, such as

older age and more comorbidities, need to be addressed by oering better

tolerated mUC tx and educating pts on the benets of systemic tx.

Previously presented at ESMO 2023, “FPN: 2386P”, “Günter Niegisch etal.” -

Reused with permission.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

298

Discontinuation of Active Surveillance in younger patients

with prostate carcinoma

Kevin Claaßen1; Christina Justenhoven2; Volker Arndt3; Silke Hermann3;

Susanne Bergbold3; Jale Lakes4; Dominique Werner1; Hiltraud Kajüter1;

Catherine Real1; Andreas Stang1; Peter Albers4

1Landeskrebsregister NRW, Bochum, Deutschland

2IDG Institut für digitale Gesundheitsdaten RLP, Mainz, Deutschland

3Epidemiologisches Krebsregister Baden-Württemberg, Heidelberg,

Deutschland

4Universitätsklinikum Düsseldorf, Klinik für Urologie, Düsseldorf, Deutschland

Background: Localized prostate carcinoma shows a very low 10-year

cancer-specic mortality of less than three percent. e strategy of Active

Surveillance can delay or avoid side eects of radical curative inter-

ventions. (1) However, the evidence concerning Active Surveillance in

younger patients below 60 years is scarce.

Methods: Based on data from the state-wide cancer registries of North Rhine-

Westphalia, Baden-Württemberg and Rhineland-Palatinate, the courses

of n = 700 patients < 60 years diagnosed with localized prostate carcinoma

between 2016 and 2021 and initially under Active Surveillance are described.

Relevant endpoints are the 2-year discontinuation rate, median time on

Active Surveillance and the presence of histological progression based on

Gleason score. Active contacting of health care providers is currently ongoing

within the framework of the research project “Prostatakarzinom des jungen

Mannes” (ProjuMa) in order to increase the completeness of the data.

Result: Relatively high discontinuation rates with low median duration

are expected, which would be not only due to histological progression of

the disease, but also due to limited adherence to the treatment strategy.

Final analyses will be available in the fourth quarter of 2023.

Discussion: Beyond the clinical rationale, both the psychological burden

of the patient as well as caution and incentive structure of the treating

physician may lead to discontinuation of Active Surveillance.

Conclusion: is study will provide a rst quantication of the rate of dis-

continuations of Active Surveillance and its association with histological

progression in young patients with localized prostate cancer in Germany.

Indication of source:

1 Hamdy et al. (2016): 10-Year Outcomes aer Monitoring, Surgery, or

Radiotherapy for Localized Prostate Cancer. In: N Engl J Med.

Disclosure Statement: e authors declare no conict of interest.

455

Characteristics and outcomes of patients (pts) with Metastatic

Castration-Resistant Prostate Cancer (mCRPC) treated with

Lutetium-177–PSMA-617 (PSMA-RLT) in a Real-World Setting

David Kersting1; Moon-Sung Kim2; Lukas Püllen3; Katharina Seidl-

Rathkopf4; Nicole Schinwald4; Philani Mpofu5; Ivy Altomare5;

Arun Sujenthiran6; Trevor Royce5; Christoph Buhl4; Viktor Grünwald3;

Ken Herrmann1; Jens Kleesiek2; Boris Hadaschik3

1Department of Nuclear Medicine, University of Duisburg-Essen and German

cancer consortium (DKTK), partner site University Hospital Essen, Essen,

Deutschland

2Institute for AI in Medicine (IKIM), University of Duisburg-Essen and German

cancer consortium (DKTK), partner site University Hospital Essen, Essen,

Deutschland

3Department of Urology, University of Duisburg-Essen and German cancer

consortium (DKTK), partner site University Hospital Essen, Essen, Deutschland

4Flatiron Health GmbH, Köln, Deutschland

5Flatiron Health Inc., New York, USA

6Flatiron Health UK Ltd, London, United Kingdom

Background: is retrospective cohort study describes characteristics

and real-world (rw) overall survival (OS) of pts with mCRPC treated with

PSMA-RLT at Essen University Hospital (UKE). We contextualize these

ndings with results from a US-based mCRPC cohort that did not receive

PSMA-RLT.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 85

Methods: e UKE cohort included mCRPC pts treated with ≥ 1 cycle

of PSMA-RLT from 11/2017 to 10/2022. Data comprised structured and

unstructured data from UKE’s electronic health record (EHR). e US

cohort was selected from the nationwide EHR-derived Flatiron Health

database. It included pts with mCRPC diagnosis (dx) from 01/2014 to

09/2021 who received tx (=index tx) following ≥ 1 taxane and ≥ 1 andro-

gen receptor pathway inhibitor (ARPI).

Result: In the UKE cohort (N = 219, median (med) age: 73, interquartile

range (IQR): 67, 78) med time from initial dx and mCRPC dx to the initi-

ation of PSMA-RLT was 69 mos (IQR: 42, 128) and 23 mos (IQR: 13, 40),

respectively. Pts were heavily pre-treated (≥ 2 taxanes: 27.8%; ≥ 2 ARPIs:

58.9%). Disease burden at tx start was extensive, as indicated by sites of

metastases (bone: 95%, lymph nodes: 82.6%). Med OS from the start of

PSMA-RLT was 9.8 mos (95% CI: 8.6, 11.3). In the US cohort (N = 857,

med age = 71, IQR: 65, 78) 11.1% of pts received prior tx with ≥2 taxanes

and 35% with ≥ 2 ARPIs. Disease burden at index tx was as follows: bone:

91.5%, lymph nodes: 51.5%. Med time from initial dx and mCRPC dx to

index tx was 49 mos (IQR: 27, 99) and 16 mos (IQR: 10, 25), respectively.

Med OS for US patients was 8.5 mos (95% CI:7.6, 9.1).

Discussion: e study design did not allow for a direct comparison

between the two cohorts. Qualitatively, UKE patients were heavily

pre-treated with extensive disease burden at the start of PSMA-RLT.

Nevertheless, the study demonstrated promising rw outcomes for patients

with mCRPC under PSMA-RLT.

Conclusion: is study provided the unique opportunity to describe rw

outcomes for late stage mCRPC patients treated with PSMA-RLT. Future

work, including the direct comparison of PSMA-RLT versus other tx in a

similar setting, will help understand the benet of this novel tx.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

499

e-Konsil - Teleconsultations for urological tumors

Marianne Leitsmann1; Boris Pöhlmann2; Björn Broge2; Mark Schrader3;

Chris Protzel4; Maurice-Stephan Michel5; Susanne Krege6; Michael Siebels7

1Klinik für Urologie, Medizinische Universität, Graz, Österreich

2aQua-Institut GmbH, Göttingen, Deutschland

3Klinik für Urologie, Helios Klinik, Berlin-Buch, Deutschland

4Klinik für Urologie, Helios Klinik, Schwerin, Deutschland

5Universitätsklinik für Urologie und Urochirurgie, Universität Heidelberg-

Mannheim, Mannheim, Deutschland

6Klinik für Urologie, Evang. Kliniken Essen-Mitte, Essen, Deutschland

7Urologie Pasing, München, Deutschland

Purpose: Patients have the right to the best possible treatment. Especially

in complex oncological cases, seeking a second opinion can be benecial.

Methods: e platform ‘e-Konsil’ (https://www.ekonsil.org/) facilitates

teleconsultations for patients with testicular tumors, penile carcinoma,

or metastatic renal cell carcinoma, oering the opportunity for nation-

wide expert opinions. e treating physician completes medical data and

planned therapy in an input matrix with patient consent. ese are then

forwarded to a specialist for assessment, who provides recommendations.

e follow-up documentation captures the therapy actually performed, as

well as entity-specic outcomes up to 6 years.

Results: Since 2017, a total of 3876 expert opinions have been requested

by 906 participants. ese have been reviewed by 47 experts. is corre-

sponds to approximately 15% of all urologists in Germany. e alignment

of therapy plans resulted f.e. in a modication of treatment decisions in

about 30% of testicular tumor cases. Similar was also observed for the

other two entities.

Discussion: e Teleconsultation Agreement according to § 291g SGB V

will allow billing through the EBM in the future and entry into standard

care provision. erefore, teleconsultations will become an integral part

of medical care in the future. In addition to the further development of

the process (integration with the Telematik infrastructure, DICOM image

transmission, second opinion procedures, automated billing), the plat-

form e-Konsil aims to transfer the model to other oncological specialties.

Conclusions: Telemedical consultations enhance the quality of patient

care, facilitate local treatment by the familiar healthcare provider, and are

accessible on a regional as well as cross-sectoral basis.

Disclosure Statement: e authors declare no conict of interest.

745

Interim analysis (IA) from RENALISTIC: a retrospective chart

review of rst-line (1L) therapy in patients with advanced

renal cell cancer (aRCC) in Germany

Christian Doehn1; Peter Brecht2; Rosemary E. Teresi3; Gina Rüter4;

Ulrike Osowski5; Mairead Kearney5; Allison Thompson3; Rainer Lipp2

1Urologikum Lübeck, Lübeck, Deutschland

2GermanOncology GmbH, Hamburg, Deutschland

3Pzer Inc, New York, USA

4Pzer Pharma GmbH, Berlin, Deutschland

5Merck KGaA, Darmstadt, Deutschland

Background: e treatment of aRCC has signicantly changed in recent

years. Prior to the approval of combination therapies, tyrosine kinase

inhibitor (TKI) monotherapy was considered the standard 1L therapy

of aRCC. Immune checkpoint inhibitor (ICI) + TKI/ICI combinations

were approved in the EU in 2019 and 2020, respectively. RENALISTIC

launched in Oct 2022 to gather real-world data on the uptake/outcomes

of new therapies in Germany. We report results of an IA including the rst

50 patients.

Methods: RENALISTIC is an anonymized retrospective chart review of

patients who started 1L for aRCC in oncological and urological insti-

tutions from 2020-2021. An IA assessing value of documentation and

derived information was planned. Descriptive analyses were conducted

and the Kaplan-Meier method was used to assess time-to-event outcomes.

Results: Data from 50 patients from 10 institutions (urology/oncology,

12%/88%; practice/hospital, 92%/8%) were evaluable through April 15,

2023. erapies received were reported as ICI+TKI: 42%, ICI+ICI: 20%,

TKI alone: 30%, ICI alone: 8%. e median progression-free survival

(PFS) (months) diered by treatment; ICI+TKI: 9.1, ICI+ICI: 2.7, TKI

alone: 3.2, ICI alone: 1.6. Median follow-up was 13.8 months. At time

of analysis, 76% (n=38) had discontinued 1L due to progressive disease

(n=13), physician/patient wish (n=8), death (n=7), performance status

deterioration (n=4), toxicity (n=3), and unknown (n=3).

Discussion: e use of combination therapy for the treatment of aRCC

has been observed following regulatory approvals; this is reected in the

highest proportion of patients in this IA receiving ICI+TKI in 1L. For

ICI+TKI, median PFS was 9.1 months, which is consistent with clinical

trials and similar studies.

Conclusion: Limitations of this IA include the small number of patients

and missingness of data; however, the value of documentation was con-

rmed, and RENALISTIC will continue. Additional patients and fol-

low-up will provide information on toxicity management and treatment

approaches of medical disciplines/institutions.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts86

750

Toxicity and Ecacy after Fiducial-based Stereotactic Body

Radiotherapy in Prostate Cancer witht a Linear Accelerator

(LINAC)

Simon KB Spohn1,2,3; Marco Serpa2,4; Rolf Wiehle2,4; Paolina Toncheva1,2;

Carlotta Rizzo4; Sophie Küchler2,4; Thomas Rothe2,4; Simon Kirste1,2,2;

Constantinos Zamboglou1,2,5; Dimos Baltas2,4; Anca-L. Grosu1,2

1Department of Radiation Oncology - University Medical Center Freiburg,

Freiburg, Deutschland

2German Cancer Consortium (DKTK) Partner Site Freiburg -German Cancer

Research Center (DKFZ), Heidelberg, Deutschland

3Berta-Ottenstein-Programm, Faculty of Medicine, University of Freiburg,

Freiburg, Deutschland

4Department of Radiation Oncology, Division of Medical Physics, University

Medical Center Freiburg, Freiburg, Deutschland

5German Oncology Center, European University of Cyprus, Limassol, Zypern

Background: Localised prostate cancer (PCa) can be treated with ste-

reotactic body radiotherapy (SBRT) in a few sessions and ablative doses.

Intrafractional movement of the prostate poses a challenge to safe treat-

ment delivery. Here we present the toxicity and ecacy at a median fol-

low-up (FU) of 18 months aer ducial-based image-guided radiotherapy

(IGRT) at the conventional linear accelerator (LINAC).

Methods: 8 patients who received SBRT between February 2021 and

August 2022 were included in this analysis. SBRT was delivered aer

implantation of 3 ducials in 5 fractions with prescribed doses between

36.25 and 40 Gy using volumetric intensity modulated arc therapy

(VMAT). An IGRT workow with combined stereoscopic imaging and

cone beam computer tomography was used. Imaging was performed at

predened times during treatment. Table corrections were applied in 6

DOF if a threshold of >1° rotation or >1 mm translation was exceeded. FU

was performed every 3-6 months. Gastrointestinal (GI) and genitourinary

(GU) toxicity was assessed by CTCAEv5.

Result: Median PSA before RT was 8.7 ng/ml (6.1 - 15ng/ml). Median

FU was 18 months (12-30 months). Figure 1 shows GU and GI toxicities

at end of treatment, 3 months, 12 months and at last FU. ere were no ≥

grade III toxicities. At last FU, no ≥ grade II toxicities were observed and

mean PSA was 0.95 ng/ml (0.2-2.6ng/ml).

Discussion: SBRT delivered with the ducial-based workow shows very

low toxicity rates aer a median FU of 18 months. Only one grade II tox-

icity was observed at the last FU. e large PSA reduction to a median of

<1ng/ml suggests a successful ablative treatment.

Conclusion: SBRT can be safely delivered with correction of intrafrac-

tional motion with a LINAC. SBRT with focal dose escalation based on

functional imaging is currently being investigated in the HypoFocal

SBRT trial.

Disclosure Statement: e authors declare no conict of interest.

816

Achieving an undetectable PSA <0.1ng/ml following

SRT predicts the outcome of patients receiving SRT for

biochemical recurrence following RP

Sophia Scharl1,2; Luca Gartner2; Dirk Böhmer3; Alessandra Siegmann3;

Daniel Zips4; Reinhard Thamm1; Manuel Krafcsik2; Benjamin Mayer5;

Thomas Wiegel2

1Universitätsklinikum Ulm, Ulm, Deutschland

2Universitätsklinikum Ulm, Ulm, Deutschland

3Charité Campus Mitte, Berlin, Deutschland

4Charité Campus Mitte, Berlin, Deutschland

5Universität Ulm, Ulm, Deutschland

Background: Achieving an undetectable PSA <0.1ng/ml following SRT

has been demonstrated to predict the outcome of patients by previous

publications. e aim of this retrospective study was to evaluate whether

this eect persists in an updated larger cohort with longer follow-up time.

Methods: 678 prostate cancer patients of two university centers treated

with SRT to the prostatic fossa for BR aer RP were included. Exclusion

criteria were lymph node or distant metastases before SRT, pre-SRT

PSA>3ng/ml and ADT between RP and SRT. Log-rank test and Cox

regression analysis were used to evaluate the impact of disease and treat-

ment related parameters on BPFS, MFS and OS.

Result: Median follow-up time aer SRT was 5.6 years. 5- year BPFS was

77.8% in patients with a PSA nadir <0.1 ng/ml and 16.3% in the remaining

cohort (p<0.001). 5- year MFS was 95.3% in patients with undetectable

PSA versus 84.0% in those with detectable PSA following SRT (p<0.001).

5- year OS was 97.5% in patients with a PSA nadir <0.1 ng/ml and 92.7%

in the remaining cohort (p=0.04). In multivariate analysis, PSA nadir <0.1

ng/ml remained a statistically signicant predictor for BPFS (p <0.001,

HR: 8.202, 95%-CI: 5.357-12.557) and MFS (p<0.001, HR: 3.813, 95%-CI:

1.986-7.322), but not for.

Discussion: The prognostic value of PSA nadir <0.1 ng/ml on OS was

only present in univariate analysis. The reason for PSA nadir losing

its predictive power in multivariate analysis might be the high age

average of patients with prostate cancer and the option of ADT as sal-

vage treatment. Patients that achieved an undetectable PSA following

SRT had an excellent outcome, whereas the remaining patients had a

terrible outcome. Considering these results, it seems plausible to take

PSAresponse to SRT into account when thinking about adding ADT

to SRT.

Conclusion: PSA <0.1 ng/ml following SRT without ADT is a signi-

cant predictor of BPFS and MFS. We assume that it might be feasible to

withhold ADT in selected patients that if they achieve an undetectable

PSA aer SRT. Further prospective studies are warranted to conrm these

results.

Disclosure Statement: e authors declare no conict of interest.

848

Incidence and survival of patients with prostate cancer in a

population-based dataset

Madeleine Karpinski1; Kevin Claaßen1; Lennart Möller1; Johannes Hüsing1;

Wolfgang Fendler2; Hiltraud Kajüter1; Andreas Stang1,3

1Landeskrebsregister NRW gGmbH, Bochum, Deutschland

2Department of Nuclear Medicine, University Hospital Essen, Essen,

Deutschland

3Institute of Medical Informatics, Biometry and Epidemiology, University

Hospital Essen, Essen, Deutschland

Background: is analysis gives an update on the incidence of pros-

tate cancer and its survival. We especially studied the incidence in rela-

tion to changing recommendations on Prostate-Specic-Antigen (PSA)

screening.

Methods: Age-standardized incidence rates and 5-year relative survival

(RS) (period approach) were calculated using data from the cancer reg-

istry of the administrative district Münster and North Rhine-Westphalia

respectively for the years 1992-2019. Analyses were stratied according to

the TNM classication.

Result: Until 2008 overall prostate cancer incidence increased, fol-

lowed by a decrease up to 2017 and another increase. The same time

trend was observed only in non-metastatic tumors but not in met-

astatic tumors. Incidence of tumors with lymph node metastases

increased before and decreased after 2017. Overall 5-year RS showed

an increase of +12% up to period 2006-2007, after that it remains

constant. The median survival with non-metastatic prostate cancer

(96.02%) or with lymph node metastases (92.04%) was higher com-

pared to distant metastases (49.9%).

Discussion: Incidence rates reect changes of recommendation in PSA

screening guidelines from the United States. e increase in non-meta-

static tumors in particular aer 2017 may reect increased PSA screening.

An increase in RS can be an expression of lead time bias.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 87

Conclusion: Higher survival rates in local tumors and tumors with lymph

node metastases show, that the challenge is to detect distant metastases

early. Incidence rates demonstrate that disease progression cannot be

mastered by PSA screening alone, but possibly by additionally applied

diagnostic methods in the future.

Disclosure Statement: e authors declare no conict of interest.

868

Symptomatic vs. non-symptomatic urothelial carcinoma:

5-years results from the VERSUS study

Christian Doehn1; Frank König2; Jörg Klier3; Robert Schönfelder4;

Manfred Johannsen5; Jörg Schröder2; Elke Hempel6;

Rolf Harald Eichenauer7

1Urologikum Lübeck, Lübeck, Deutschland

2ATURO, Berlin, Deutschland

3UPK, Köln, Deutschland

4Urologie Schönfelder & Strasser, Hamburg, Deutschland

5Urologie Johannsen & Laux, Berlin, Deutschland

6SMGF, Berlin, Deutschland

7Urologikum Hamburg, Hamburg, Deutschland

Background: Since May 2018, members of d-uo have been document-

ing urologic tumor cases as part of the prospective VERSUS study. We

asked ourselves whether there are dierences between symptomatic and

non-symptomatic patients with urothelial carcinoma regarding age and

tumor stage at initial diagnosis.

Methods: By April 2023, 16,916 patients with an initial diagnosis of urologic

tumor disease were documented. Urothelial carcinoma was present in 4,205

patients (24.9%). ere were 3,250 men (77.3%) and 955 women (22.7%).

Result: Urothelial carcinoma was diagnosed due to symptoms in 2,313

patients (55%) and by another route in 1,892 patients (45%). e median

patient age, with no relevant gender dierence, was 71.5 years in patients

with symptoms and 71.3 years in patients without symptoms. e dis-

tribution of UICC stages were (symptomatic patients/non-symptom-

atic patients): UICC 0: 47.3%/55.3%; UICC I: 28.4%/25.5%; UICC II:

16.5%/11.7%; UICC III: 2.4%/2.3%; UICC IV: 5.4%/3.8%.

Discussion: We herein present current real world data from Germany

demonstrating that patients with urothelial carcinoma and symptoms do

not dier in age from patients with any other cause of diagnosis. However,

patients with symptoms show less favorable tumor stages.

Conclusion: Our nding may have impact on early diagnosis as well as

staging and therapy of patients with urothelial carcinoma.

Disclosure Statement: e authors declare no conict of interest.

890

PSMA-PET and mpMRI-based focal dose escalation in

denitive radiotherapy of prostate cancer: 2-year results of

the HypoFocal phase II study

Simon KB Spohn1,2,3; Mark Gainey4; Marius Kamps5; Cordula Annette Jilg5;

August Sigle5; Christian Gratzke5; Michael MIX6; Martin Freitag6;

Sophia Louisa Bürkle1; Tanja Sprave1,2; Simon Kirste1,2; Hannes Engel7;

Sebastian Zschaeck8,9; Pirus Ghadjar8; Dimos Baltas2,4;

Constantinos Zamboglou1,2,10; Anca-L. Grosu1,2

1Department of Radiation Oncology, University Medical Center Freiburg, Faculty

of Medicine, University of Freiburg, Freiburg, Deutschland

2German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer

Research Center (DKFZ), Heidelberg, Deutschland

3Berta-Ottenstein-Programm, Faculty of Medicine, University of Freiburg,

Freiburg, Deutschland

4Department of Radiation Oncology, Division of Medical Physics, University

Medical Center Freiburg, Faculty of Medicine, Freiburg, Deutschland

5Department of Urology, University Medical Center Freiburg, Faculty of

Medicine, University of Freiburg, Freiburg, Deutschland

6Department of Nuclear Medicine, University Medical Center Freiburg, Faculty

of Medicine, University of Freiburg, Freiburg, Deutschland

7Department of Radiology, University Medical Center Freiburg, Faculty of

Medicine, University of Freiburg, Freiburg, Deutschland

8Department of Radiation Oncology, Charité—Universitätsmedizin Berlin,

Corporate Member of Freie Universität Berlin and Humboldt-Universität zu

Berlin, Berlin, Deutschland

9German Cancer Consortium, Partner Site Berlin, Heidelberg, Deutschland

10German Oncology Center, European University of Cyprus, Limassol, Zypern

Background: e prospective, 2-armed, non-randomised phase II

HypoFocal trial investigates the safety and feasibility of PSMA-PET

and mpMRI-based focal dose-escalated moderately hypofractionated

radiotherapy (MHRT) and high-dose-rate brachytherapy (HDR-BT) in

patients with prostate cancer (PCa). Here we present the two-year toxicity

(tox) and quality of life (QoL) results.

Methods: Patients with NCCN intermediate/high risk PCa (cN0 cM0)

received MHRT of 60 Gy in 20 Fx in arm A or HDR-BT of 15 Gy followed

by RT of 44 Gy in 20 Fx in arm B. Target volumes, treatment plans, gas-

trointestinal (GI) and genitourinary (GU) tox according to CTCAE v5.0

were analysed. Quality of life was assessed using the QLQ30, PR25 and

IPSS questionnaires. 23 patients in arm A and 18 in arm B received aFU

for 2 years.

Results: 25 patients were treated in each arm in two centres (FR and B).

In arms A and B 76% and 48% had unfavourable intermediate risk, 24%

and 36% high risk, respectively. Median boost volumes were 10.2 ml (arm

A) and 6.8 ml (arm B).

2-year grade 2 GU and GI tox was 8% and 4% in arm A. No grade 3 tox

was observed. At 12 months, two patients experienced grade 3 GI tox due

to multifactorial pathogenesis. 2-year grade 2 GU and GI tox was 17%

and 0% without any grade 3 tox in arm B. QoL analysis (response rate

50-60%) showed only small signicant dierences for bowel symptoms in

arms A and B and for sexual function in arm B. Median PSA at 2 years was

0.23ng/ml in arm A and 0.33 ng/ml in arm B.

Discussion: e 2-year FU shows good tolerability and QoL despite large

boost volumes. e Covid19 pandemic aected the response rate of the

QoL questionnaires.

Conclusions: e use of PSMA-PET in addition to mpMRI in focal

dose-escalated RT appears to be safe. However, radioproctitis demands

careful interdisciplinary management. PSMA-PET- and mpMRI-based

focal dose escalation in combination with stereotactic body radiotherapy

(SBRT) will be investigated in the currently recruiting HypoFocal phase

III trial.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts88

906

Lenvatinib plus Pembrolizumab as rst-line treatment in

patients with advanced renal cell carcinoma (aRCC) – real

world data from a retrospective multi-center analysis

Ramona Stelmach1; Katrin Schlack2; Clemens Mühle3; Christopher Darr4;

Stephanie Neuberger5; Mathias Reichert6; Marc Rehlinghaus7;

Luka Flegar8; Friedemann Zengerling9; Jozena Casuscelli10;

Alexander Cox11; Tim Nestler12; Timo Egenolf13; Bernhard Brehmer14;

Sonia Vallet15; Philipp Ivanyi16; Manuel Neuberger17; Pia Paenholz18;

Viktor Grünwald4; Stefanie Zschäbitz1

1Department of Medical Oncology, National Center for Tumor Diseases,

Heidelberg University Hospital, Heidelberg, Deutschland

2Department of Urology, University Hospital Münster, Münster, Deutschland

3Department of Urology, Klinikum Rechts der Isar, Technical University Munich,

München, Deutschland

4Department of Urology, University of Duisburg-Essen and German Cancer

Consortium (DKTK-)University Hospital Essen, Essen, Deutschland

5Department of Urology and Pediatric Urology, University Medical Center of

Johannes Gutenberg University, Mainz, Deutschland

6Department of Urology, University Medicine Göttingen, Göttingen,

Deutschland

7Department of Urology, University Hospital Düsseldorf, Düsseldorf,

Deutschland

8Department of Urology, Philipps-University Marburg, Marburg, Deutschland

9Department of Urology and Pediatric Urology, University Hospital Ulm, Ulm,

Deutschland

10Department of Urology, University Hospital, Ludwig Maximilian University of

Munich, München, Deutschland

11Department of Urology, University Hospital Bonn, Bonn, Deutschland

12Department of Urology, Federal Armed Services Hospital Koblenz, Koblenz,

Deutschland

13Department of Urology and Pediatric Urology, University Hospital Würzburg,

Würzburg, Deutschland

14Department of Urology, Diakonie Hospital, Schwäbisch Hall, Deutschland

15Department of Internal Medicine II, University Hospital Krems, Krems an der

Donau, Österreich

16Department of Hematology, Hemostasis, Oncology and Stem Cell

Transplantation, Claudia-von Schelling Comprehensive Cancer Center,

Hannover Medical School, Hannover, Deutschland

17Department of Urology and Urological Surgery, Medical Faculty Mannheim of

the University of Heidelberg, Mannheim, Deutschland

18Department of Urology, Uro-Oncology, Robot-Assisted and Reconstructive

Urologic Surgery, University of Cologne, Faculty of Medicine and University

Hospital Cologne, Köln, Deutschland

Background: Combinations of checkpoint inhibitors and tyrosine kinase

inhibitors are contemporary standard of care (SOC) in rst-line patients

with aRCC. Real-world evidence remains scarce. We investigated the

tolerability and ecacy of lenvatinib (LEN) and pembrolizumab (PEM)

under real-world conditions.

Methods: We retrospectively analyzed clinical data from patients with

aRCC who started LEN (20 mg OD) plus PEM (200 mg every 3 or 400

mg every 6 weeks) as SOC-rst-line treatment at 18 tertiary centers in

Germany and Austria between October 2020 and June 2023. Objective

response rate (ORR) was analyzed according to RECIST 1.1. Adverse

events (AE) were assessed by CTCAE v5.0.

Results: We included 134 patients in this analysis. Median age was 63

years (range 41-87). e majority of patients were male (71%). IMDC

risk group was favorable, intermediate, and poor in 27% 51% and 22%.

46% of patients did not meet the inclusion criteria of the CLEAR trial,

mainly due to CNS involvement, concomitant diseases or an ECOG ≥2.

AEs occurred in 90% of patients, with fatigue (49%), hypertension (39%)

and diarrhea (37%) as most common AE. AE grade ≥ 3 were seen in

52%. Steroids for immune-related AE were required in 25% of patients.

Interruption of at least one of the drugs due to toxicities was required

in 55% and dose reduction of LEN in 52% of patients. LEN-PEM was

permanently discontinued due to toxicities in 19%. ORR was 69%, with

9% achieving a complete remission. Primary progression was detected

in 10% of patients. At a median follow-up time of 10.9 months, 31%

experienced disease progression. Progression-free survival at 6 months

was 76% (95%CI: 68-84). 17% of patients died, most of them due to

progressive disease.

Discussion: Our results demonstrate ecacy and feasibility of LEN-PEM,

also in patients who are not considered trial-eligible. Objective response

and tolerability are comparable to the pivotal CLEAR trial. A limitation is

the short follow-up duration.

Conclusion: Our retrospective analysis supports the use of LEN-PEM as

SOC-rst-line treatment for patients with aRCC.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

919

Early-detected vs. otherwise-detected prostate cancer:

5-years results from the VERSUS study

Frank König1; Rolf Harald Eichenauer2; Manfred Johannsen3;

Robert Schönfelder4; Jörg Klier5; Jörg Schröder1; Elke Hempel6;

Christian Doehn7

1ATURO, Berlin, Deutschland

2Urologikum Hamburg, Hamburg, Deutschland

3Urologie Johannsen & Laux, Berlin, Deutschland

4Urologie Schönfelder & Strasser, Hamburg, Deutschland

5UPK, Köln, Deutschland

6SMGF, Berlin, Deutschland

7Urologikum Lübeck, Lübeck, Deutschland

Background: Since May 2018, members of d-uo have been documenting

urologic tumor cases as part of the prospective VERSUS study. We asked

ourselves whether there are dierences between early-detected and other-

wise-detected patients with prostate cancer regarding age and tumor stage

at initial diagnosis.

Methods: By April 2023, 16,916 patients with an initial diagnosis of uro-

logic tumor disease were documented. Prostate cancer was present in

10,664 patients (63.0%).

Result: Prostate cancer was early-detected in 5.543 patients (52.0%) and

by another route in 5.331 patients (48.0%). e median age was 69.8

years in patients with early-detected and 70.8 years in patients with oth-

erwise-detected prostate cancer. e distribution of UICC stages were

(early-detected/otherwise-detected): UICC I: 63.8%/51.1%; UICC II:

18.6%/16.7%; UICC III: 91.1%/8.6%; UICC IV: 8.5%/16.6%.

Discussion: We herein present current real world data from Germany

demonstrating that patients with early-detected prostate cancer are

younger than patients with otherwise-detected prostate cancer. However,

patients with early-detected prostate cancer show more favorable tumor

stages.

Conclusion: Our nding may have impact on early diagnosis as well as

staging and therapy of patients with prostate cancer.

Disclosure Statement: e authors declare no conict of interest.

922

Symptomatic vs. non-symptomatic renal cell carcinoma:

5-years results from the VERSUS study

Manfred Johannsen1; Jörg Klier2; Frank König3; Robert Schönfelder4;

Rolf Harald Eichenauer5; Jörg Schröder3; Elke Hempel6; Christian Doehn7

1Urologie Johannsen & Laux, Berlin, Deutschland

2UPK, Köln, Deutschland

3ATURO, Berlin, Deutschland

4Urologie Schönfelder & Strasser, Hamburg, Deutschland

5Urologikum Hamburg, Hamburg, Deutschland

6SMGF, Berlin, Deutschland

7Urologikum Lübeck, Lübeck, Deutschland

Background: Since May 2018, members of d-uo have been document-

ing urologic tumor cases as part of the prospective VERSUS study. We

asked ourselves whether there are dierences between symptomatic and

non-symptomatic patients with renal cell carcinoma regarding age and

tumor stage at initial diagnosis.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 89

Methods: By April 2023, 16,916 patients with an initial diagnosis of uro-

logic tumor disease were documented. Renal cell carcinoma was present

in 1,306 patients (7.7%). ere were 909 men (69.6%) and 397 women

(30.4%).

Result: Renal cell carcinoma was diagnosed due to symptoms in 333

patients (25.5%) and by another route in 973 patients (74.5%). e

median patient age, with no relevant gender dierence, was 65.0 years

in patients with symptoms and 66.3 years in patients without symptoms.

e distribution of UICC stages were (symptomatic patients/non-symp-

tomatic patients): UICC I: 51.3%/72.9%; UICC II: 9.1%/8.8%; UICC III:

18.3%/13.0%; UICC IV: 21.3%/5.4%.

Discussion: We herein present current real world data from Germany

demonstrating that patients with renal cell carcinoma and symptoms do

not dier in age from patients with any other cause of diagnosis. However,

patients with symptoms show less favorable tumor stages.

Conclusion: Our nding may have impact on early diagnosis as well as

staging and therapy of patients with renal cell carcinoma.

Disclosure Statement: e authors declare no conict of interest.

Geriatric Oncology

183

Frail – B: A prospective interdisciplinary trial to evaluate a

systematic two-step frailty screening before gynaecological

oncology surgery

Katharina Gillen1; Valerie Linz2; Marcus Schmidt2; Walburgis Brenner2;

Annette Hasenburg2; Marco Battista2

1Jung-Stilling-Krankenhaus, Diakonie Klinikum, Siegen, Deutschland

2Universitätsmedizin Mainz, Mainz, Deutschland

Purpose: Frailty as an underdiagnosed multidimensional age-related syn-

drome has grown in importance for the need of a better understanding of

the health and functional status of older persons. is study investigates

the impact of a standardized, two-step multidisciplinary frailty assess-

ment concerning the perioperative outcome in women with gynaecolog-

ical malignancies.

Methods: In this prospective clinical trial, all women with gynaecolog-

ical malignancies regardless of the histological type and previous treat-

ments have been systematically screened preoperatively at the University

Medical Centre Mainz since May 2020. All participants take part in the

two-step frailty assessment with selected screening tools (Screening I+II),

peripheral blood results as well as a comprehensive geriatric assessment

(CGA) if necessary. e main outcome measures are the association of

the preoperatively evaluated frailty status with perioperative laboratory

results, intraoperative surgical parameters, the incidence of immediate

postoperative in-hospital complications and the oncological outcome.

Results: is is an ongoing trail. So far, 158 patients have been recruited

for the study including patients with ovarian cancer (n= 56; 35.4%), endo-

metrial cancer (n=52; 32.9%), cervical cancer (n=7; 4.4%), vulvar and

vaginal cancer (n=33; 20.9%), and other gynaecological tumours (n=10;

6.3%). 57 (36.1%) patients have been classied as G8-frail according to the

G8 geriatric screening tool and underwent the second frailty assessment.

Discussion: To ensure a possible operationalization of frailty, we have

initiated a two-step frailty assessment in our department. is screening

helps to identify a signicant proportion of women who should receive

perioperative optimization of their global health status to provide their

best individual surgical treatment

Conclusion: A standardized frailty assessment especially for elderly

women with gynaecological cancer might identify patients with worse

prognoses and with a signicant high rate of severe postoperative

complications.

Disclosure Statement: e authors declare no conict of interest.

187

Association of functional status, blood biomarkers and overall

survival in older patients with lymphoma – a monocentric,

retrospective study

Antje Jensch1; Eva Mennig1; Susanne Walz1; Simone Neumaier1;

Ruth Elisa Eyl-Armbruster1; Markus Knott1,2; Alexander Friedl3;

Ralf Lobmann3; Pascale Regincos2; Roswitha Uibeleisen2; Gerald Illerhaus2

1Stuttgart Cancer Center (SCC) - Tumorzentrum Eva Mayr-Stihl, Klinikum

Stuttgart, Stuttgart, Deutschland

2Department of Hematology, Oncology and Palliative Care, Klinikum Stuttgart,

Stuttgart, Deutschland

3Department of Endocrinology, Diabetology and Geriatrics, Klinikum Stuttgart,

Stuttgart, Deutschland

Background: Elderly oncological patients constitute an increasing

amount at Klinikum Stuttgart. To investigate their therapy resources, a

geriatric-hematologic assessment (GA) was introduced. We aimed to

evaluate if functional status according to GA relates to blood biomarkers

and overall survival of lymphoma patients.

Methods: e GA consists of standardized physical and neurocognitive

diagnostic instruments that provide a functional status (“t”; “vulnera-

ble”; “frail”). For the analyses, data from 2009 to 2022 was used. Patients

were selected by disease entity (ICD C81-88, C90, C96) and functional

classication. Survival times were evaluated using Kaplan-Meier curves

for subgroups of dierent levels of haemoglobin (Hb), albumin, lactate

dehydrogenase (LDH) and c-reactive protein (CRP).

Result: Between 2009 and 2022, GA was performed on 286 patients diag-

nosed with lymphoma with a median age of 77 years (60-95). Functional

status was available for 255 lymphoma patients (118 (46%) “t”, 109 (43%)

“vulnerable”, 28 (11%) “frail”). “Fit” patients with lower Hb values had a lower

median survival time (MST) (low: 2.9 years, normal: 8.5 years). Elevated

CRP values were also associated with a lower MST in “t” patients (high:

2.8 years, normal: 7.0 years). Additionally, “t” and “vulnerable” patients

with high LDH values showed a lower MST compared to normal LDH val-

ues (high: 3.7 years, normal: 6.8 years and high: 0.9 years, normal: 2.5 years,

respectively). Albumin was not reasonably evaluable due to the small num-

ber of values available. Overall, lower functional status was associated with

lower proportions of normal values for all biomarkers except Hb.

Discussion: Functional status according to GA is reected in blood bio-

markers of lymphoma patients and, to some extent, in survival probability.

is is especially true for “t” patients.

Conclusion: e GA is a useful clinical tool to map overall health resources

of older oncological patients before starting therapy. Nevertheless, high

CRP and high LDH are associated with a decreased MST despite “t” status.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts90

Gynecologic Cancer

Get us to know

Andrea Krull

Gynäkologische Krebserkrankungen Deutschland e.V., Neumünster,

Deutschland

Association: Gynecological Cancer Germany e.V. / Focus OC

Association and VOICE for woman with abdominal cancers!

Five abdominal cancers - one voice !

Aim: GynKD e.V. and doctors - together for better treatment, prevention,

aercare and knowledge.

Key words: Abdominal, Ovarian Cancer, gyn.cancer, accompaniment,

enlightenment, networks, QoL, cooperation, empowerment

Introduction: Association: Gyn. Cancers Germany e.V. (GynKD e.V.) is

well known Patient Advocate Organisation which enlightens patients,

empowers them to improve quality of life and ll their need for informa-

tion and exchange. We raise awareness, knowledge, prevention.

Our vision: To empower and inform - to give fundamental knowlege/

information within Germany, Austria and Switzerland.

Association: Is strong voice in Germany, within doctors, stakeholders,

medical organisations, media and federal authorities. Since 2020 expanded

to support those aected by cervical-, vulva and endometrial cancer.

Background: Ovarian Cancer incidens: 7800 women / year. Other gyn.

cancer: 28.703 woman/year - Complete mortality : Germany : approx.

20.503 women (source 1).

OUR Association - wants to introduce itself with poster and presentation

to show its misssion, projects, services to strengthen patients / independ-

ent research!

Listen to our presentation how to support best abdominal cancer patients

Vision: Information, Collaboration, Exchange, Empowerment

ere is an urgent need of signicant support in care, information and

education for abdominal cancer patients.

• e number of gynecological patients should be reduced/earlier

detected.

• prevention, treatment, aercare should be uniformly treated in com-

petence centers, practicing GPs and gynecologists should be better

focused on sympthomes and trained in communication.

• public and young women should be entlightend.

• high need of understandable information: Prerehabilitation, understand-

able trials, more/better terminal care, better communication and support.

Disclosure Statement: e authors declare no conict of interest.

107

First Interim Analysis of the SCOUT-1 Study (NOGGO ov54,

NCT04830709): A Non-Interventional Study to evaluate

Treatment Patterns and Longterm Outcome in Patients with

Newly Diagnosed Advanced Ovarian Cancer

Klaus Pietzner1,2; Elena Ioana Braicu1,2; Pauline Wimberger2,3;

Jessika Goldmann4; Karol Kubiak5; Nikolaus de Gregorio6; Julia Radosa7;

Bahriye Aktas2,8; Angelika Ober9; Cosima Brucker10;

Philipp Meyer-Wilmes2,11; Badrig Melekian12; Jacqueline Sagasser2,13;

Dagmar Guth14; Andreas Schnelzer15; Svetlana Tchaikovski16;

Björn Lampe17; Svenja Diemert18; Jalid Sehouli1,2

1Department of Gynecology European Competence Center for Ovarian Cancer,

Campus Virchow-Klinikum, Charité Medical University, Berlin, Deutschland

2North-Eastern German Society of Gynecological Oncology (NOGGO), Berlin,

Deutschland

3Department of Gynecology and Obstetrics, University Hospital Carl Gustav

Carus, TU Dresden, Dresden, Deutschland

4Department of Obstetrics and Gynecology, DRK Kliniken Berlin, Berlin,

Deutschland

5Department of Obstetrics and Gynecology, St. Franziskus-Hospital, Münster,

Deutschland

6Department of Obstetrics and Gynecology, SLK Kliniken, Heilbronn,

Deutschland

7Department of Gynecology, Obstetrics and Reproductive Medicine, University

Medical School of Saarland, Homburg/Saar, Deutschland

8Department of Gynecology, University of Leipzig Medical Center, Leipzig,

Deutschland

9Department of Obstetrics and Gynecology, St Vincenz Hospital Limburg,

Limburg, Deutschland

10Paracelsus Medical University, University Women’s Hospital, Klinikum

Nürnberg, Nürnberg, Deutschland

11Department of Gynecology and Obstetrics, University Hospital RWTH Aachen,

Aachen, Deutschland

12Department of Obstetrics and Gynecology, St. Marien-Krankenhaus Siegen,

Siegen, Deutschland

13Department of Gynecology and Obstetrics, University Hospital Augsburg,

Augsburg, Deutschland

14Gynecologic Oncology, Praxis Dr. med. Dagmar Guth, Plauen, Deutschland

15RoMed Klinikum Rosenheim, Department of Obstetrics and Gynecology,

Rosenheim, Deutschland

16Department of Gynecology and Obstetrics, Otto-Von-Guericke University,

Magdeburg, Deutschland

17Department of Gynecology and Obstetrics, Florence Nightingale Hospital,

Düsseldorf, Deutschland

18AstraZeneca, Hamburg, Deutschland

Background: Current standard of care for advanced ovarian cancer

(OC) consists of upfront surgery, with the goal of complete macroscopic

resection, platinum-based chemotherapy (pCTX) and maintenance ther-

apy (MTX) with poly(ADPribose) polymerase inhibitors (PARPi) or

bevacizumab as monotherapy or in combination. e prospective, non-

interventional SCOUT-1 study (NOGGO ov54, NCT04830709) was initi-

ated to assess treatment patterns including MTX and long-term outcome

in patients with newly diagnosed advanced OC in Germany.

Methods: 750 patients providing written informed consent, with com-

pleted surgery (if applicable), eligible for pCTX, tested for BRCA1/2

mutations (BRCAm) and willing/able to complete PROs electronically, are

planned to be enrolled and followed for up to 7 years.

Aim of the study is to analyze cohorts of special interest (PARPi MTX,

bevacizumab MTX, no MTX). Interim analyses were dened at 175, 250

and 375 enrolled patients, followed for 6 months, to assess the distribu-

tion across cohorts, safety and gain rst insight into characteristics of

patients.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 91

Result: First 175 patients were enrolled between June 15th 2021 and

November 20th, 2022. Of these, 159 were eligible and included in the

analysis (median age 60 years, ECOG ≤1: 98.7%; concomitant disease:

72.3%). Most tumors were in FIGO stage III (74%) and of serous his-

tology (92%). BRCAm were detected in 23.3% and non-BRCA HRD

positivity in 45.2% of tumours tested. 91% of patients underwent

debulking surgery, 98% used carboplatin and paclitaxel as 1L pCTX and

91% received targeted therapy. Adverse drug reactions were consistent

with known tolerability prole of substances used in the 1L and mostly

related to MTX.

Conclusion: First SCOUT-1 data reect current real-world practice and

transfer from phase III trials into clinical routine. Future analysis should

dene the barriers to improve the quality of care.

Disclosure Statement: e authors declare the following:

154

Impact of preoperative determined global health assessment

tools on the outcome of patients with vulva and vaginal

cancer – results of the prospective, observational,

single-center study (FRAIL-B)

Katharina Gillen1; Valerie Catherine Linz2; Emma Rosemarie Liebau2;

Maria Schröder2; Wolfang Weikel2; Alexander Seeger2; Roxana Schwab2;

Marcus Schmidt2; Annette Hasenburg2; Marco Battista2

1Jung-Stilling-Krankenhaus, Diakonie Klinikum, Siegen, Deutschland

2Universitätsmedizin Mainz, Mainz, Deutschland

Purpose: Frail-B is a prospective, observational, single-center study

to assess the impact of pre-operatively determined frailty status on the

outcome of patients with gynecological malignancies. In this subgroup-

analysis, we describe the results for women aected by vulva cancer (VC)

and vaginal cancer (VaC).

Methods: Patients 60 years and older with VC and VaC, being operated

at the University Medical Center Mainz from June 2020 until June 2023,

entered in these analyses. ey were assessed with a two-step frailty algo-

rithm using the G8 geriatric screening questionnaire (G8-Score) and the

LEE-Schonberg prognostic index (LEE-Index).

Results: 31 patients (three with VaC) were included. Mean age was 73.5

years (±7.2 years). 16 patients (51.6%) were classied as G8-frail and 14

(45.2%) had an estimation of life <15% for the next four years according to

the LEE-Index. ree (9.7%) patients received an individual, less radical

surgical approach out of them all were preoperatively classied as G8-frail

(p=0.078) or LEE-frail (p=0.041). Frail patients in total were associated

with a signicantly decrease of 2-years-overall-surival (G8-Score: 53.8%

vs. 100.0%, p=0.041 and LEE-Index: 53.0% vs. 100.0%, p=0.036).

Discussion: Frailty as a multidisciplinary aging-related syndrome of

physical decline characterized by an excessive vulnerability to endog-

enous and exogenous stressors with adverse health outcomes. Vulvar

cancer is an uncommon disease that primarily aects older women.

Oncologic prognosis in the elderly is signicantly impaired due to mul-

tiple reasons. Identifying patients being not frail using validated tools

may help to identify patients requiring standard surgical care. Our

results underline the necessity of a preoperative standardized frailty

assessment in VC and VaC.

Conclusions: Frailty assessment with standardized screening-tools prior

to surgical treatment may assist to identify elderly patients with VC and

VaC in whom the standard surgical approach may be benecial.

Disclosure Statement: e authors declare no conict of interest.

270

Phase 3 MIRASOL (GOG 3045/ENGOT-ov55) Trial:

Mirvetuximab Soravtansine (MIRV) Prolongs Overall Survival

vs Investigator’s Choice Chemotherapy (IC) in Platinum-

Resistant Ovarian Cancer (PROC) with High Folate Receptor-

Alpha (FRα) Expression

Felix Hilpert1; Philipp Harter2; Domenica Lorusso3; Gottfried. E. Konecny4;

Susana Banerjee5; Nicoletta Colombo6; Yuemei Wang7; James Stec7;

Michael Method7; Toon Van Gorp8; Kathleen Moore9;

Nikolaus de Gregorio10

1Krankenhaus Jerusalem Hamburg, & AGO Study Group, Hamburg, Deutschland

2Kliniken Essen-Mitte gGmbH & AGO Study Group, Essen, Deutschland

3Fondazione Policlinico Universitario A Gemelli Istituto di Ricerca e Cura a

carattere scientico (IRCCS), Rom, Italien

4UCLA Jonsson Comprehensive Cancer Center, Los Angeles, USA

5Royal Marsden Hospital, London, United Kingdom

6European Institute of Oncology IRCCS and University of Milan-Bicocca,

Mailand, Italien

7ImmunoGen, Inc., Waltham, USA

8Leuven Cancer Institute & BGOG, Leuven, Belgien

9University of Oklahoma Health Sciences Center, Oklahoma City, USA

10Klinikum am Gesundbrunnen, SLK-Kliniken Heilbronn GmbH & AGO Study

Group, Heilbronn, Deutschland

Background: Mirvetuximab soravtansine (MIRV), an antibody-drug con-

jugate targeting FRα. MIRASOL is a randomized phase 3 trial of MIRV vs

standard-of-care chemotherapy in patients (pts) with PROC

Methods: 453 PROC pts with high FRα expression (Roche FOLR1 Assay)

were randomized 1:1 to MIRV 6 mg/kg, adjusted ideal body weight, Day

1 of a 21-day cycle or IC: paclitaxel, pegylated liposomal doxorubicin, or

topotecan. e primary ecacy endpoint was progression-free survival

(PFS) by investigator (INV), key secondary endpoints ORR, and overall

survival (OS), other endpoints included safety and tolerability.

Result: 227 pts were randomized to the MIRV; 226 to the IC . Baseline

characteristics were well balanced across arms; 14% of pts had one, 39%

two, and 47% three prior lines of therapy (PLOT); 62% received prior bev;

and 55% received prior PARPi therapy. e study met its primary and

key secondary endpoints with statistically signicant results in PFS 5.62

months vs. 3.98 months (PFS HR 0.65 [0.52, 0.81]); ORR 42.3 vs. 15.9;

and OS 16.46 months vs. 12.75 months (OS HR 0.67 [0.50, 0.88] favor-

ing MIRV. In subset analyses, pts with 1 or 2 PLOT, PFS HR was 0.61

(0.45, 0.81); and 3 PLOT, PFS HR was 0.71 (0.52, 0.98), the OS HR was

0.66 (0.45, 0.98) for 1 or 2 PLOT; and 0.65 (0.43, 0.96) for 3 PLOT. In pts

with prior PARPi, PFS HR was 0.58 (0.43, 0.78) and ORR 45% vs 17%. In

PARPi naïve, PFS HR was 0.74 (0.54, 1.03) and ORR 40% vs 14%.

e adverse event (AE) prole of MIRV was consistent with prior reports:

predominantly low-grade ocular (MIRV vs IC all grade 56% vs 9%; grade

3+ 14% vs 0%) and gastrointestinal events (MIRV vs IC all grade 70% vs

66%; grade 3+ 13% vs 15%). Compared with IC, MIRV was associated

with lower rates of grade 3+ treatment-emergent AEs (42% vs 54%), seri-

ous AEs (24% vs 33%), and discontinuations due to TEAEs (9% vs 16%).

Conclusion: MIRV is the rst treatment to demonstrate a PFS and OS

benet in PROC compared to IC with demonstrate consistent benet

across subgroups. e ecacy data, along with the well-characterized

safety prole, position MIRV as a new, standard of care for pts with FRα

positive PROC.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts92

290

FRAIL-B: Preoperative G8 geriatric screening tool for ovarian

cancer patients to identify women with a worse perioperative

outcome

Katharina Gillen1; Valerie Catherine Linz2; Marcus Schmidt2;

Annette Hasenburg2; Marco Battista2

1Jung-Stilling-Krankenhaus, Diakonie Klinikum, Siegen, Deutschland

2Universitätsmedizin Mainz, Mainz, Deutschland

Background: Frail patients with ovarian cancer (OC) should be identi-

ed preoperatively to reduce their risk of adverse surgical outcomes. We

present rst results of a systematic, preoperative frailty screening of OC

patients regarding their perioperative outcome.

Methods: OC patients regardless of the previous treatments or the his-

tological type were screened preoperatively by the G8 geriatric screening

tool. If a patient was considered to be G8-frail (cut-o: ≤ 14points), multi-

ple geriatric assessment tools followed. e main outcome measures were

the relationship between perioperative laboratory results, intraoperative

surgical parameters and the incidence of immediate postoperative in-

hospital complications with the preoperative frailty status.

Results: So far, 42 OC patients treated with laparotomy for tumour

debulking/extirpation were included at the University Medical Centre

Mainz between May 2020 and May 2023. Mean age was 69.2 years. Most

of the patients (71.4%) hadadvanced stage OC (≥ FIGO IIB). e G8-frail

cohort seemed to have a higher prevalence of polypharmacy (p=0.098)

and more surgical revisions (21.1 vs. 4.3%; 51 p=0.158) than the G8-non-

frail cohort. Furthermore, the G8-frail cohort appeared to have a longer

mean hospital stay (10.7 vs. 17.7 days; p=0.096) and appeared to be read-

mitted to hospital more oen than the G8-non-frail cohort (15.8 vs. 8.7%;

p=0.096). One patient in each cohort died during hospital stay.

Discussion: Preoperative frailty assessment with the G8 geriatric screen-

ing tool for elderly women with OC might indicate polypharmacy, a lon-

ger hospital stay and a higher rate of readmission. Further results will be

expected soon.

Conclusion: Preoperative determined global health status using G8 geri-

atric screening tool might identify elderly patients beeing at high risk for

severe complications.

Disclosure Statement: e authors declare no conict of interest.

314

Surgical resection based on ontogenetic cancer eld theory

for cervical cancer: 10-year updated results of the MMR study

Laura Weydandt; Benjamin Wolf; Nadja Dornhöfer; Bahriye Aktas

Universitätsklinikum Leipzig, Leipzig, Deutschland

Background: In the MMR study we aimed to determine whether surgical

treatment that accounts for stage-associated, ontogenetic cancer elds and

their associated lymphoid tissues results in locoregional tumor control

without the need for adjuvant radiotherapy.

Methods: e Leipzig School Mesometrial Resection Study (MMR

study) is an ongoing, prospective, single-center, observational cohort

study including patients with primary cervical cancer. All study partici-

pants undergo either total or extended mesometrial resection (TMMR or

EMMR) and therapeutic lymph node dissection. Because this treatment

strategy enables surgical removal of all locoregional at-risk tissues, no

adjuvant radiotherapy is necessary, even in the presence of established risk

factors. For this updated analysis, we identied patients in our study data-

base with primary cervical cancer staged IB1 – IIA2 according to the 2009

International Federation of Gynecology and Obstetrics staging system.

Result: Between October 16, 1999, and December 16, 2020, 420 patients

were treated per protocol and followed up for a median of 136 months

(IQR 77-190). 329 patients (78.3%) had stage IB1, 58 (13.8%) stage IB2,

24 (5.7%) stage IIA1 and 9 (2.1%) stage IIA2 disease. e nodal status was

pN0 in 349 (83.1%) patients and pN1 in 71 (16.9%) of the cases. 10-year

overall survival was 90.2% (95% condence interval [CI] 87.1-93.4) and

recurrence-free survival was 90.6% (95% CI 87.8-93.6). Stratied for

lymph node status 10-year overall survival was 91.7% (95% condence

interval [CI] 88.5-95) for pN0 and 83.2% (95% condence interval [CI]

74.6-92.9) for pN1. Recurrence-free survival was 93.8% (95% CI 91.2-

96.5) for pN0 and 75.4% (95% CI 65.9-86.3) for pN1.

Conclusion: Despite dispense of adjuvant radiotherapy, patients treated

with total or extended mesometrial resection with therapeutic lymph

node dissection have excellent survival outcomes.

is abstract was accepted and previously presented at the 2023ASCO Annual

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

323

Is this the downfall of Gynecologic Oncology? Using the

example of outpatient specialist care (ASV)–gynecologic

tumors without subspecialization

Theresa Link; Pauline Wimberger

Uniklinik Dresden/Gynäkologie, Dresden, Deutschland

Background:

e future of the gynecologic oncology is in jeopardy. Gynecologic sur-

geries performed by general surgeons and systemic treatment of gyneco-

logical cancers by medical oncologist are some examples.

e membership in the ASV for gynecological tumors without subspe-

cialization requires successful subspecialization in Gynecologic Oncology

for gynecologists, but majority of these spend most of their time in the

operating room in an impatient setting. A gynecologist without this sub-

specialization is explicitly excluded from ASV even with specialization for

systemic tumor therapy if passed aer December 2015.

Methods: Based on the homepage asv-servicestelle.de all existing ASV

teams – gynecologic tumors without subspecialization were listed, core

teams were counted by speciality and team leader were captured by

profession.

All ASV teams were contacted via email and all chairs of the

Landesärztekammern of the respective state were asked to provide num-

bers of doctors with successful exam for Gynecologic Oncology in 2021

and 2022.

Result: In total, there are 116 ASV teams listed for gynecological tumors

without subspecialization in Germany. Overall, there are only 320 (23%)

gynecologists, 510 (36%) internists and 551 (39%) radiation oncologists

included in the core teams. But 66% of the team leaders are gynecologists.

Up to now 14 federal states provided numbers of successful examens

for Gynecologic Oncology. In 2021 45 gynecologists passed the examen

mainly in Bavaria and Baden-Württemberg. 10 states reported only 0 to

3 examens per year.

More numbers will be provided at the congress.

Discussion: Many standards in Gynecologic Oncology worldwide were

set by gynecologists. With the rapid progress and rising complexity, a

focus on systemic treatment by highly specialized physicians is more than

necessary.

Conclusion: In regard to the low numbers of gynecologists in the ASV

and the low numbers of exams it is very likely to lose the systemic treat-

ment in gynecology.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 93

355

GynTect® Methylation Markers detect recurrent disease in

patients treated for CIN3 with high sensitivity and specicity

in a retrospective case-control study

Heike Hoyer1; Cornelia Scheungraber2; Grit Mehlhorn3; Ingke Hagemann4;

Sarah Scherbring5; Linn Wölber6; Annett Petzold7; Kristina Wunsch8;

Martina Schmitz8; Monika Hampl9; Gerd Böhmer10; Peter Hillemanns11;

Ingo B. Runnebaum7; Matthias Dürst7

1Institut für Medizinische Statistik, Informatik und Datenwissenschaften,

Universitätsklinikum Jena Jena, Deutschland

2Frauenarztpraxis Dr. med. Cornelia Scheungraber Jena, Deutschland

3Frauenarztpraxis PD Dr. med. Grit Mehlhorn Erlangen, Deutschland

4abts+partner Partnerschaftsgesellschaft Kiel, Deutschland

5Fachärzte für Frauenheilkunde und Geburtshilfe Braunschweig, Deutschland

6Klinik für Gynäkologie, Universitätsklinikum Hamburg-Eppendorf Hamburg,

Deutschland

7Klinik und Poliklinik für Frauenheilkunde und Fortpanzungsmedizin,

Universitätsklinikum Jena Jena, Deutschland

8Ongnostics GmbH Jena, Deutschland

9Frauenklinik, Universitätsklinikum Düsseldorf Düsseldorf, Deutschland

10Institut für Zytologie und Dysplasie (IZD) Hannover, Deutschland

11Klinik für Frauenheilkunde und Geburtshilfe, Medizinische Hochschule

Hannover (MHH) Hannover, Deutschland

Background: Post-treatment follow-up in women with CIN3 is manda-

tory due to relapse in up to 10% of patients. Standard follow-up based on

hrHPV-DNA/cytology co-testing has high sensitivity but limited speci-

city. e aim of our case-control study was to evaluate the performance

of the methylation test GynTect® for the detection of recurrent CIN2/3

during follow-up.

Methods: Residual clinical material from an observational study with a

focus on HPV/cytology co-testing was analysed (PMID34282754). We

studied a sample of 48 patients (median age 31 years) comprising 17 cases

with recurrent CIN2/3 diagnosed within 24 months and 31 controls. All

of them had at least one follow-up visit. DNA from cervical scrapes at

baseline (before CIN3 surgery) and follow-up visits were analysed for

13hrHPV types and the GynTect® methylation status.

Result: Overall 15 of 48 patients were GynTect-negative at baseline. Of the

33 GynTect-positive patients at baseline 12 were diagnosed with recurrent

disease. Two of these patients were neither hrHPV- nor GynTect-positive

during follow-up. One patient was hrHPV-positive but GynTect-negative

and 9 patients were hrHPV- and GynTect-positive during follow-up.

Sensitivity was not signicantly dierent for GynTect (75%, 95% CI 46%-

92%) and hrHPV (83%, 95% CI 55%-96%) (McNemar p=1.00). Two of

21 patients who were GynTect-positive at baseline but without evidence

for recurrent disease were both hrHPV- and GynTect-positive during fol-

low-up. Six patients were hrHPV-positive but GynTect-negative and 13

patients were negative for both tests. Specicity was signicantly higher

for GynTect (90%, 95% CI 71%-98%) compared to hrHPV (62%, 95% CI

40%-80%) (McNemar p=0.03).

Conclusion: For initially GynTect-positive patients both hrHPV and

GynTect® assays detect recurrent disease with similar sensitivity but the

GynTect® assay has a signicantly higher specicity. A future study will

have to show whether cytology/GynTect® co-testing will out-perform

cytology/hrHPV co-testing in post-treatment surveillance for this sub-

group of CIN3 patients.

Disclosure Statement: e authors declare the following: MD is founding

member, advisory board member and minority shareholder of oncgnostics GmbH.

KW is employed as an R&D scientist at oncgnostics GmbH. MS is founding

member, CSO and minority shareholder of oncgnostics GmbH.

426

Inuence of the molecular subtype of epithelial ovarian

cancer (EOC) on MDSC induction

Lena Marie Wahl1; Gabriele Diamante1; Daniel Rapp2; Kerstin Kitt3;

John Park3; Klaus-Michael Debatin1; Jan Lewerenz2; Gudrun Strauss1

1University Medical Center Ulm, Department of Pediatrics and Adolescent

Medicine, Ulm, Deutschland

2University Medical Center Ulm, Department of Neurology, Ulm, Deutschland

3Boehringer Ingelheim GmbH KG & Co, Biberach, Deutschland

Background: Epithelial ovarian cancer (EOC) is characterized by high

malignancy and poor anti-tumor immunity. EOC is classied into 5

dierent molecular subtypes (Mes, Epi-A, Epi-B, Stem-A and Stem-B).

Myeloid-derived suppressor cells (MDSCs) as part of the tumor micro-en-

vironment (TME) strongly contribute to immunosuppression and tumor

immune escape. ey are signicantly increased in OC patients and indic-

ative for malignancy and treatment refractory. erefore, an association

between OC subtypes and MDSC induction and function might help

identifying biomarkers of low immunogenic tumor subtypes.

Methods: OC cell lines with dened molecular subtypes and primary

tumor samples, for which the subtype is dened by Nanostring analy-

sis, are used in MDSC induction assays by co-culturing tumor cells with

PBMCs. We aim to investigate MDSC numbers and suppressive ability

and the expression of MDSC inducing factors among molecular subtypes

of OC.

Results: Co-culture of PBMCs with OC cell lines of dierent molecular

subtypes showed that only the Mes phenotype of OC, associated with the

poorest outcome, eciently induced MDSCs while all other subtypes are

poor MDSC inducers. M-MDSCs are the prominent MDSC fraction and

transwell assays indicated that MDSC induction requires cell-cell contact.

is is further supported as Mes OC cells do not express elevated levels

of pro-inammatory factors described to activate MDSCs. Mes-induced

MDSCs eciently inhibit T-cell proliferation while the suppressive

function of MDSCs induced by other molecular subtypes is still under

investigation.

Discussion: e Mes phenotype of OC could be associated to increased

MDSC induction. Studies with primary tumor cells and PBMCs will clar-

ify whether this association can be conrmed with patient material.

Conclusions: Dening an association between molecular tumor markers

and the cellular composition of the TME might help to identify patients

with poor anti-tumor immunity and thereby impact treatment strategies.

Disclosure Statement: e authors declare the following: John Park und Kerstin

Kitt stehen in einem Beschäigungsverhältnis mit Boehringer Ingelheim

Pharma GmbH & Co. KG. Lena Wahl und Daniel Rapp werden zum Teil über

Forschungsunterstützung von Boehringer Ingelheim Pharma GmbH & Co. KG

bezahlt.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts94

450

Managing Immune-Related Adverse Events Following

Immune-Checkpoint Therapy in Patients with Gynecologic

Cancer – A Survey from Germany, Austria, and Switzerland

Maximilian Riedel1,2; Helene Herrmann1,3; Thomas Bartl1,4;

Anna-Maria Rossner1,5; Anna Tatzber1,6; Chiara Flethe1,7; Dario Zocholl8;

Barbara Schmallfeldt9; Jalid Sehouli1,10; Klaus Pietzner1,10

1Young Academy of Gynecologic Oncology (JAGO), Nord-Ostdeutsche

Gesellschaft für Gynäkologische Onkologie (NOGGO), Berlin, Deutschland

2Department of Obstetrics and Gynecology, Klinikum rechts der Isar, Technical

University Munich, München, Deutschland

3Department of Gynecology and Obstetrics, Division of Gynecologic Oncology,

Hospital Waldfriede Berlin, Berlin, Deutschland

4Department of Obstetrics and Gynecology, Division of General Gynecology

and Gynecologic Oncology, Comprehensive Cancer Center, Medical University

Vienna, Wien, Österreich

5Department of Gynecology and Obstetrics, Gynecologic Oncology, St. Josefs-

Hospital Wiesbaden GmbH, Aliated Hospital of Medical University of Mainz,

Mainz, Deutschland

6Department of Gynecology with Breast Center, Charité Mitte, Medical

University Berlin, Berlin, Deutschland

7Department of Gynecological Oncolocy, Charité Campus Virchow, Charité

Medical University, Berlin, Deutschland

8Charité Medical University Berlin, Corporate member of Freie Universität

Berlin and Humboldt-Universität zu Berlin, Institute of Biometry and Clinical

Epidemiology, Berlin, Deutschland

9Department of Gynaecology and Gynaecologic Oncology, University Medical

Center Hamburg-Eppendorf, Hamburg, Deutschland

10Department of Gynecology with Center for Oncological Surgery, Virchow

Campus Clinic, Charité Medical University, Berlin, Deutschland

Background: e application of immune-checkpoint therapy has gained

momentum in the treatment of gynecological malignancies in recent

years. is study aimed to explore gynecologists’ viewpoints and experi-

ences concerning immune-checkpoint inhibitor therapy in gynecological

oncology and tried to unravel its current implementation, challenges, and

potential approaches for managing side eects.

Methods: A questionnaire was distributed via diverse channels to physi-

cians collecting data from October 2022 to May 2023.

Result: e study included 221 participants. A majority specialized in

gynecological oncology (59.1%), occupying various clinical positions:

residents (41.8%), specialized physicians (19.5%), consultants (31.8%),

and clinical directors (5.9%). Most were aliated with university hospitals

(54.1%), followed by accredited tumor centers (30.73%), ambulant prac-

tices (10.1%), and non-accredited clinics (4.1%). Participants reported

an average of 26 patients treated with immune-checkpoint inhibitors

throughout their clinical careers. Side eects under immune-checkpoint

therapy varied, with thyroiditis, skin reactions, and pneumonitis being the

most common. Over 80% have admitted or referred patients for inpatient

treatment due to side eects; severe side eects necessitating intensive

care (33.6%) or patient mortality (7.4%) were also observed. e aware-

ness of long-term eects was signicant, with a majority of participants

inquiring about immune-mediated side eects during post-treatment fol-

low-ups beyond six months.

Discussion: is study sheds light on the application of immune-check-

point therapy in routine gynecological oncology. Robust side eect man-

agement strategies, improved education, and vigilance during long-term

follow-up are essential for optimizing patient outcomes and therapeutic

success.

Conclusion: Further research should focus on rening management

strategies and educational resources for optimal patient care in gyneco-

logical oncology.

Disclosure Statement: e authors declare no conict of interest.

593

G8-geriatric screening tool indicates a higher revision rate

preoperatively in gynecologic oncology patients

Valerie Catherine Linz1; Marco Battista1; Emma Rosemarie Liebau1;

Marcus Schmidt1; Annette Hasenburg1; Katharina Gillen²

1Department of Gynecology and Obstetrics, University Medical Center of the

Johannes Gutenberg University Mainz, Mainz, Deutschland

2Abteilung Gynäkologie, Jung-Stilling-Krankenhaus, Diakonie Klinikum, Siegen,

Deutschland

Purpose: is prospective, single-center study investigates a preoperative

frailty screening for gynecologic oncology patients undergoing tumor

surgery.

Methods: All gynecologic oncology patients aged 60 years and older par-

ticipated in a standardized frailty assessment with the G8-geriatric screen-

ing tool before tumor surgery at the University Medical Center Mainz

from May 2020 till August 2023.

Results: 193 patients were screened preoperatively and 159 patients were

included, comprising patients with ovarian (n=51, 32.1%), endometrial

(n=57, 35.8%), cervical (n=7, 4.4%), vulvar (n=30, 18.9) and vaginal (n=3,

1.9%) cancer. 59 (37.1%) patients were classied as G8-frail (≤ 14 points)

according to the G8-geriatric screening tool and underwent a second

frailty assessment. Mean age was 70.0 (+/- 7.8) years. G8-frail patients

had numerically but not statistically signicantly higher deviation rates

of their guideline-recommended standard therapy for their respective

tumor entity (15.3% vs. 7%; p=0.108). Furthermore, the G8-frail patients

had more surgical revisions (16.9% vs. 5%; p=0.022) and seemed to have a

longer hospital stay (p=0.072) than the G8-non-frail cohort. During mean

follow-up of 10.2 (+/-9.9) months, more patients died in the G8-frail

cohort than in the G8-non-frail cohort (15.3 vs. 5.0%, p=0.041).

Discussion: To ensure a possible operationalization of frailty, a frailty

assessment was established in our gynecologic oncology department. Frail

patients need prehabilitation before surgery and in some cases an individ-

ualized surgical approach. However, elderly patients classied as not being

frail require standardized surgical therapy to not impair their oncologic

prognosis due to a less radical surgery.

Conclusion: e G8-screening tool is a simple and short test for older

gynecologic oncology patients that can be easily implemented in the clin-

ical routine and appears to be a good marker for surgical revisions in the

frail cohort.

Disclosure Statement: e authors declare no conict of interest.

599

Induction of prostate specic membrane antigen (PSMA)

on endothelial cells by incubation with tumor-conditioned

medium of dierent ovarian cancer cell lines

Sophia Persin; Markus Jäger; Felix Hertel; Ingolf Juhasz-Böss; Clara Unger

Klinik für Frauenheilkunde, Universitätsklinikum Freiburg, Freiburg,

Deutschland

Background: Due to the poor prognosis of ovarian cancer, there is a need

for new diagnostic and therapeutic approaches. PSMA was detected on

neovasculature of various malignant tumors.1 Its induction on endothelial

cells could be achieved by incubation with tumor-conditioned medium

(TCM) of various tumor cell lines.2 ere is evidence that PSMA may

function as a pro-angiogenic factor and thus aect tumor development.

e aim of this work is to show PSMA induction on endothelial cells,

under incubation with TCM of dierent ovarian cancer cell lines and to

investigate the eect of hypoxia on PSMA expression.

Methods: Human Umbilical Vein Cells (HUVECs) are cultured in the

extracellular matrix Geltrex™ and incubated with TCM of ovarian cancer

cell lines (EFO-21, OAW-42, SK-OV-3). e colon cancer cell line HCT-15

serves as a positive control and the cell line HOSE-6 (ovarian epithelium)

as a negative control. PSMA expression will be determined by RT-qPCR.

Detection at the protein level will be performed by immunocytochemis-

try. For the experiments under hypoxia, a gas mixture with 3% O2 is used.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 95

Result: e results will be shown on site.

Discussion: e induction of PSMA on HUVECs by incubation with

TCM may provide clues to the role of PSMA in a regulatory pathway.

Ovarian cancer cells seem to secrete factors that induce PSMA expression

on endothelial cells, whereby PSMA may promote tumor development as

a pro-angiogenic factor.

Conclusion: If PSMA induction is shown on endothelial cells by incuba-

tion with TCM of ovarian cancer cell lines, PSMA may be a suitable target

in diagnosis and targeted tumor therapy of ovarian cancer.

Indication of source:

1 Chang SS, Gaudin PB et al. Five dierent anti-prostate-specic membrane

antigen (PSMA) antibodies conrm PSMA expression in tumor-associated

neovasculature. Cancer Res. 1999;59(13):3192–3198.

2 Nguyen DP, Liu H, et al. Induction of PSMA and Internalization of an

Anti- PSMA mAb in the Vascular Compartment. Mol Cancer Res.

2016;14(11):1045–1053.

Disclosure Statement: e authors declare no conict of interest.

724

N-acetylaspartylglutamate (NAAG) - synthetases I and II

inovarian cancer

Philipp Groß1; Markus Jäger1; Soe Schoenhals1; Felix Hertel1;

Claudia Nöthling1; Ingolf Juhasz-Böss1; Clara Unger1; Konrad Kurowski2;

Peter Bronsert2,3

1Klinik für Frauenheilkunde - Universitätsklinikum Freiburg, Freiburg im

Breisgau, Deutschland

2Uniklinik Freiburg - Institut für Klinische Pathologie, Freiburg im Breisgau,

Deutschland

3Core Facility für Histopathologie und Digitale Pathologie Freiburg,

Universitätsklinikum Freiburg, Freiburg im Breisgau, Deutschland

Background: N-acetylaspartylglutamate (NAAG), a prevalent neu-

rotransmitter in the brain, has been detected in ovarian cancer (1). A

proven positive correlation exists between NAAG levels in tumor/serum

and in vivo tumor growth (1). e role of NAAG in ovarian cancer

remains unclear. Our study aims to demonstrate hypoxia-induced expres-

sion of NAAG synthetase-encoding RIMKL A and B genes, followed

by NAAG level measurement. We also plan to immunohistochemically

detect RIMKL A and B in primary high-grade serous ovarian carcinoma

patients and correlate its expression with survival and clinical parameters.

Methods: We conducted cell experiments on ovarian cancer (COV-362,

EFO-27, OAW-42, SK-OV-3) and one epithelial cell line (HOSE) under

chemical hypoxia (CoCl2) for dened durations (3h, 6h, 12h, 24h). We

used qPCR, Western blots, immunocytology, and viability assays for eval-

uation. Mass spectrometry determined NAAG levels in cells and medium.

A tissue microarray (TMA) of 61 ovarian cancer patients’ samples was

immunohistochemically stained for RIMKL A and B using HaloAI so-

ware (Indicalabs, Albuquerque, USA).

Result: Hypoxia led to elevated RIMKL A expression across all cell lines,

conrmed at the protein level through Western blot analysis. Additional

ndings will be presented on site.

Discussion: Gene induction showed temporal variation between RNA

and protein levels, hinting at potential feedback mechanisms.NAAG’s

conversion to glutamate presents a potential alternative energy pathway

for tumors. In this case, tumors with high NAAG concentrations may

have a growth advantage.

Conclusion: If there is a correlation between RIMKL A/RIMKL B expres-

sion and clinicopathological progression of the patients, the expression of

this, as well as the serum NAAG concentration if applicable, could serve

as a predictive marker.

Indication of source:

Nguyen et al.Uncovering the role of N-acetyl-aspartyl-glutamate as a glutamate

reservoir in cancer. Cell Rep.2019;27:491–501 e6. doi:10.1016/j.celrep.2019.03.

Disclosure Statement: e authors declare no conict of interest.

741

Characteristics, Treatment Patterns and Survival of FIGO Stage

IV Epithelial Ovarian Cancer – a Population Based Study

Dorothee Jakob2, Claudia Schmoor1; Raphael Reuten2; Marie Louise

Frevert2; Dominik Dannehl3; Silke Hermann4; Peter Jungmann2; Moritz

Breitbach2; Andreas Hartkopf3; Ingolf Juhasz-Boss2; Florin-Andrei Taran2

1Universitätsklinikum Freiburg, Klinik für Frauenheilkunde, Deutschland

2Universitätsklinikum Freiburg, Institut für Experimentelle und Klinische

Pharmakologie und Toxikologie, Deutschland

3Universitätsklinikum Tübingen, Klinik für Frauenheilkunde, Deutschland

4Universitätsklinikum Freiburg, Zentrum für Klinische Studien, Deutschland

Purpose: e aim of the study was a description of an unselected popu-

lation of patients with primary diagnosis of FIGO stage IV ovarian can-

cer (OC) regarding baseline patient and tumor characteristics, treatment

strategies and prognosis.

Methods: We utilized the Baden-Württemberg Cancer Registry to iden-

tify FIGO stage IV OC patients registered during a period of 8 years, data

of 1183 patients were analysed.

Results: 669 of the patients (56.6%) received any kind of surgery, 881

(68.6%) were treated with systemic therapy, and 523 (44.2%) received both

surgery and systemic treatment. 221 patients (18.7%) did not receive any

treatment. Median overall survival was 1.9 years. Especially the patients

>80 years had a low overall survival rate (hazard ratio of age >80 years vs.

≤50 years was 3.81, 95%-condence interval [2.76,5.27]. Regarding histo-

logical subtypes, survival was best for patients with HGSOC (p<0.0001).

e highest overall survival rate was observed for patients that underwent

surgery followed by systemic treatment with an unadjusted hazard ratio

vs. systemic treatment only of 0.67, 95%-condence interval [0.55,0.84].

Discussion: Our study shows that patients with FIGO IV OC benet

from surgical treatment which is reected in current treatment recom-

mendations. In contrast to available data, we could show that over 80%

of the patients received cancer-directed treatment for FIGO stage IV OC.

e strengths of this study include the analysis of a large dataset from the

Baden-Württemberg Cancer Registry, with over 1100 patients with FIGO

stage IV OC and the time span of 8 years. Limitations are the retrospective

nature of the study and missing data on possible confounders.

Conclusion: In this large cohort of patients with FIGO stage IV OC over

80% of the patients received cancer directed treatment. Age and high

grade serous histology were determining factors for survival. e highest

overall survival rate was observed for patients with FIGO stage IV OC that

underwent surgery followed by systemic treatment.

Disclosure Statement: e authors declare that there are conicts of interest.

econicts were submitted to the congress organizer KUKM GmbH and KUKM

can disclose them if needed.

747

Implementation and Update of guideline-derived quality

indicators for cervical cancer in gynecological cancer centers

certied by the German Cancer Society (DKG)

Frederik Stuebs1; Matthias Beckmann1; Tanja Fehm2; Christian

Dannecker3; Markus Follmann4; Thomas Langer4; Simone Wesselmann4

1Department of Gynecology and Obstetrics, Erlangen University Hospital,

Comprehensive Cancer Center Erlangen-European Metropolitan Area

of Nuremberg (CCC ER-EMN), Friedrich-Alexander-Universität Erlangen,

ErlangenGermany

2Department of Gynecology and Obstetrics, University Hospital of Düsseldorf,

Düsseldorf, Germany

3Department of Obstetrics and Gynecology, University Hospital Augsburg,

Augsburg, Germany

4German Cancer Society e.V., Berlin, Germany

Purpose: In 2008, the rst gynecological cancer centres (GCC) were

certied by the German Cancer Society (DKG). Guideline-based Quality

Indicators (QI) are a core element of the certication process. ese QI

are dened to assess the quality of care within the centres and can serve to

measure the implementation of guideline recommendation. is abstract

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts96

aims to give an overview of the developing and updating process of guide-

line based-QIs for women with cervical cancer and presents the QI results

from the certied GCC.

Methods: e QI’s are based on strong recommendations and developed

in a multiple step review process and then implemented in the certica-

tion data sheet of the certied centres. e rst set of QI’s created in 2014

was revised in the update process of the S3- Guideline in 2020. Results of

the four QI were quantitatively analyzed.

Results: In total, there are nine guideline based QI’s for cervical cancer.

Four QI’s are part of the certication process. In the treatment year 2020,

3.522 cases of cervical cancer were treated in 169 centers. e target values

for the four QI’s were met in at least 95% of the certied centers. In the

guideline update in 2020, a new QI was added to the set of QI’s “Complete

pathological report on conization ndings” and the QI “Exenteration”

was removed, due to the low number of exenterations (n = 43) performed

in2020.

Discussion: Over the years, the number of GCC has grown, and the results

of the QI and thus the quality of care within the centres was improved.

e results of the QI are used in the certication system as well as in the

guideline updates for a continuous reection and further development of

the structures.

Conclusion: QI’s derived from strong recommendations of a guideline

are an important tool to make essential parts of patient’s care measurable.

With QI, it is possible to implement guideline content quickly and sus-

tainably in the centers and enable them to draw consequences in process

optimization and treating their patients in accordance with the guidelines.

Disclosure Statement: e authors declare no conict of interest.

795

The HER2-ultra low expression of high-grade serous ovarian

cancer and endometrial cancer

Clara Unger1; Peter Bronsert2; Ingolf Juhasz-Böss1; Konrad Kurowski2

1Uniklinik Freiburg - Klinik für Frauenheilkunde, Freiburg im Breisgau,

Deutschland

2Uniklinik Freiburg - Institut für Klinische Pathologie, Freiburg im Breisgau,

Deutschland

Background: e importance of HER2-targeted therapies is increasing -

based on the results of the DESTINYBreast05 study, HER2-low tumours

are treated with a HER2-therapy. e relevance of a very low HER2

expression as a target in metastatic breast carcinomas, the so-called HER2

ultra-low breast carcinoma (with a score between 0 and 1+), is currently

being investigated within the DESTINYBreast06 study. HER2 expression

has already been described in endometrial and ovarian cancer. Within the

PANDestiny02 trial, HER2 positive genital carcinomas have been treated

with promising results.

Based on this, patient collectives with an endometrial or an ovarian

carcinoma will be evaluated regarding the HER2 ultra-low expression.

e results will then be correlated with the clinical data.

Methods: TMAs from 123 endometrial carcinoma and 61 high-grade

serous ovarian carcinoma patients were examined. Primary tissue, as well

as lymph node or distant metastases were evaluated.

e samples were immunohistochemically stained with the Ventana

antibody anti-HER2/neu (4B5) and evaluated by two pathologically expe-

rienced physicians analogously to breast carcinoma. e scores ultra low

(IHC: >0<1+), low (IHC: 1+, 2+) and high (IHC: 3+) were assigned.

Results: A Her2 ultra low expression was found in 22.6% of the ovarian

cancer samples and in 49.6% of the endometrial cancer samples. Further

results will be shown on site.

Discussion: e interim results of the PANDestiny02 trial presented on

the ASCO 2023 show that 67 patients didn’t show a IHC 2+ or 3+ expres-

sion. So HER2-low tumours were treated (1).

Is a HER2 ultra low expression sucient for a HER2 therapy indication?

Conclusions: HER2 ultra-low expression is present in the tumour entities

investigated. e clinical benet of this information has to be proven.

Indication of source:

1 Ecacy and safety of trastuzumab deruxtecan (T-DXd) in patients (pts) with

HER2-expressing solid tumors: DESTINY-PanTumor02 (DP-02) interim

results.

Funda M, Jung-Yun L et al.

J of Clin Onc202341:17.

Disclosure Statement: e authors declare no conict of interest.

944

Prostate specic membrane Antigen (PSMA) expression in

Endometrial carcinoma and its metastases

Valentine Guyon1; Konrad Kurowski2; Peter Bronsert2; Ingolf Juhasz-Böss1;

Clara Unger1

1Uniklinik Freiburg - Klinik für Frauenheilkunde, Freiburg im Breisgau,

Deutschland

2Uniklinik Freiburg - Institut für Klinische Pathologie, Freiburg im Breisgau,

Deutschland

Background: Advanced endometrial carcinoma is a therapeutic chal-

lenge. Endometrial carcinoma is the 5th most common cancer in women

in Germany. PSMA was detected in dierent tumor entities. In prostate

cancer, PSMA is a proven predictive and diagnostic marker. PSMA has

previously been detected in endometrial carcinoma, but the data on its

expression there is inconsistent. e aim of this study is to demonstrate

the expression of PSMA in tumor cells and tumor neovasculature, in pri-

mary tumors and in metastases of endometrial carcinoma patients and to

correlate them with clinicopathological parameters.

Methods: Tissue samples from 123 patients of the CCCF (Comprehensive

Cancer Center Freiburg) who underwent primary surgery for endome-

trial carcinoma were examined. A tissue microarray (TMA) was created

per patient with up to 3 samples from the central tumor tissue, 2 samples

from the tumor periphery and up to 3 samples in case of metastases. is

was followed by immunohistochemical staining of the TMA with CD31

(clone JC70A from Dako, Carpinteria, USA) as an endothelial cell marker

to determine the general vessel density, and a staining with a PSMA anti-

body (clone 3E6 from Dako). en digital-assisted analysis of the stained

TMA sections using the image analysis program QuPath® (University of

Edinburgh, Scotland) was performed.

Result: PSMA is expressed in both, tumor cells and tumor vessels. Tumor

cells were PSMA positive in 58.5% of primary tumor samples and ≥50%

of vessels in 76.4% of cases. A signicant association was demonstrated

between PSMA expression in vessels and lymphatic vessel invasion

(p=0.007) and maximum tumor size (p=0.007).

Discussion: Gordon at al. found PSMA expression in healthy prolifera-

tive endometrial cells. In the evaluated patient collective, this could not

be conrmed. Further studies are needed to allow a signicant statement

about the expression of PSMA in proliferative endometrial cells.

Conclusion: PSMA may allow for new targeted therapy alternatives for

endometrial carcinoma.

Disclosure Statement: e authors declare no conict of interest.

949

Targeting PLK1 and PLK3 sensitizes cervical cancer

to cisplatin-based chemoradiotherapy

Khayal Gasimli; Monika Raab; Nurlana Gasimli; Morva Tahmasbi Rad;

Sven Becker; Klaus Strebhardt; Mourad Sanhaji

Universitätsklinikum Frankfurt, Frankfurt am Main, Deutschland

Background: Resistance to cisplatin is a potential complication, signi-

cantly undermining the drug’s eectiveness in managing advanced or

recurrent cervical cancer (CC). Our investigation explored the molecu-

lar mechanisms governing the PLK1-PLK3 heterodimerization and its

clinical signicance in enhancing the responsiveness of cervical cancer

patients to cisplatin-based chemoradiotherapy.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 97

Methods: To explore the mechanistic details of PLK1-PLK3 heterodi-

merization in vitro and cells, we: 1) mapped the dimerization domains

in vitro using dierent fusion constructs containing either the kinase

domain, the polo box domains, or the full length of the two proteins. e

heterodimerization was monitored using co-immunoprecipitation (co-IP)

and pulldown assays in vitro. 2) We established a CC cell line expressing

an endogenously tagged version of PLK3, HeLa-V5-PLK3, using CRISPR/

Cas tagging system.

Result: In this study, we identied and functionally characterized the

heterodimer PLK1-PLK3. We found that both the kinase and polo box

domains of PLK1 and PLK3 can dimerize in vitro and cells. We discov-

ered that when DNA damage occurs, PLK3 heterodimerizes with PLK1,

causing a reduction in PLK1 activity, which is necessary to arrest the cell

cycle and allow cells to repair the DNA damage. By interfering with PLK1-

PLK3 heterodimerization, cells could bypass the checkpoint, resulting in

increased chromosomal instability as cells enter mitosis with unrepaired

damage. Furthermore, we found that patient-derived cervical cancer cells

lacking PLK3 and treated with the PLK1 inhibitor BI6727 show a high

sensitivity to cisplatin-based standard therapy.

Conclusion: e targeting the PLK1-PLK3 heterodimer could represent a

valuable therapeutic strategy for resensitizing cisplatin chemoradiothera-

py-resistant CC. Consequently, new inhibitors targeting the PLK1-PLK3

heterodimer-monomer switch represent a highly attractive new treatment

opportunity that will be anticipated in clinical trials.

Disclosure Statement: e authors declare no conict of interest.

958

Analysis of HPV16 or HPV18 DNA in peritoneal washings and

serum as molecular marker for cervical cancer patients

Katharina Kuhnigk; Angela Kather; Davit Bokhua; Ingo B. Runnebaum;

Norman Haefner

Jena University Hospital, Dept. of Gynecology, Jena, Deutschland

Background: e presence or the dynamic change of HPV fragments in

cell-free DNA (cfDNA) from blood of cervical cancer (CxCa) patients

may be used as molecular biomarker to inform about tumor expansion

and disease prognosis. However, the signicance of the HPV DNA in the

cellular or cell-free fraction of peritoneal washings (PW) is unclear.

Methods: Genomic and cfDNA from PW (n=45) and cfDNA from serum

(n=33) was isolated by commercial kits. Highly sensitive qPCR assays tar-

geting HPV16 or 18 were established and validated by articial samples.

Absolute and relative quantication of qPCR results were realized by com-

parison against plasmid dilution series or beta-actin reference sequences.

HPV results were compared to clinical parameters and the prognostic

value was analyzed by Kaplan-Meier plots and Cox regression.

Result: e level of HPV DNA fragments in the cfDNA of PW was more

strongly associated with clinical parameters (tumor expansion) or prog-

nosis (PFS, OS) than the amount of HPV in the cellular fraction of PW.

Both the level of HPV in cfDNA of PW or serum was signicantly dier-

ent in patients stratied by pT (pT1/>pT1), pN (pN0/pN1), cM (cM0/

cM1), FIGO (<IIA/≥IIA) but not by dierentiation status (G). e qual-

itative detection of HPV in cfDNA of PW or serum was not associated

with reduced survival. However, determined cut-o values could dier-

entiate patients with signicantly dierent PFS/OS (LogRank p<0.01; HR

3.5 – 6.7).

Discussion: e quantication of HPV DNA in cfDNA of both PW and

serum can inform about the expansion of the tumor and has a prognostic

value. ese data need to be conrmed in larger sample sets enabling mul-

tivariate analyses to fully evaluate this biomarker. Analyses of the dynamic

changes of HPV level in serum cfDNA are ongoing.

Conclusion: HPV DNA quantication in cfDNA may have the potential

to inform about the tumor expansion and to enable treatment decisions

pre-operatively.

Disclosure Statement: e authors declare no conict of interest.

959

Nectin-4 expression in vulvar squamous cell carcinoma - a

possible target for the treatment approach with antibody

drug conjugates (ADC)

Lars-Christian Horn1; Anne Kathrin Höhn1; Blake Gilks2; Naveena Singh2;

Bahriye Aktas3; Nadja Dornhöfer3; Ruth Hiller1

1Division of Gynecologic Pathology, University of Leipzig, Leipzig, Deutschland

2Vancouver General Hospital and the University of British Columbia, Canada,

Vancouver, Kanada

3Universitätsklinikum Leipzig AöR, Leipzig, Deutschland

Background: Nectin-4 (syn: poliovirus receptor-related protein 4;

PVRL4) served as a tumor associated inducer in various malignant

tumors including urothelial, breast, lung, colorectal, pancreatic, ovarian

cancers. Over-expression of Nectin-4 is associated with various aspects

of tumor progression like proliferation, angiogenesis, epithelial to mesen-

chymal transition, metastasis, DNA repair, tumor relapse, poor prognosis

in several types of cancer.It is a component of antibody-drug conjugate

(ADC) enfortumab vedotin (EV). ere are no data about the expression

proles of Nectin-4 in VSCC.

Methods: 55 VSCC were immunohistochemically analysed for Nectin-4

expression using a H-score (staining intensity (SI) x percentage of positive

stained tumor cells) Overall staining scores were compared to the 3-tiered

molecular subtyping of vulval carcinoma, dening p16+ve/p53wt, p16-ve/

p53mut and p16-ve/p53wt VCX. Staining evaluation of Nectin-4 was blinded

to the molecular subtype.

Results: Virtually, all VSCC represented positive immunostaining for

Nectin-4, with mean H-score of 4.8 (range 2-9). ere were no dierences

of Nectin-4 expression within the dierent molecular subtypes of VSCC:

mean H-score 5.2 (range 2-9) for p16+ve/p53wt, 4.8 (range 2-9) for p16-ve/

p53mut and 2.5 (range 2-3) for p16-ve/p53wt VSCC (p=0.27).

Conclusion: e ADC enfortumab vedotin (EV) comprised nectin-4

conjugated via a cleavable linker to the microtubule inhibitor MMAE and

was approved for the treatment of urothelial cancer. Virtually all exam-

ined VSCC showed at least weak staining for Nectin-4 within the tumor

cells. So, Nectin-4 may represent a potential target for ADC in vulvar can-

cer. ere are no dierences of Nectin-4 expression within the dierent

molecular subtypes of VCX.

Disclosure Statement: e authors declare no conict of interest.

960

Trop-2 expression in vulvar squamous cell carcinoma

(VSCC) - a possible target for the treatment approach with

antibody drug conjugates (ADC)

Lars-Christian Horn1; Anne-Kathrin Höhn1; Barhyhie Aktas2;

Nadja Dornhöfer2; Blake Gilks3; Naveena Singh3; Lien Hoang3; Ruth Hiller1

1Division of Gynecologic Pathology, University of Leipzig, Leipzig, Deutschland

2Universitätsklinikum Leipzig AöR, Leipzig, Deutschland

3Vancouver General Hospital and the University of British Columbia, Canada,

Vancouver, Kanada

Background: e Trophoblast Cell Surface Antigen 2 (TROP-2) is asso-

ciated with invasiveness and tumor progression in several malignancies.

Strong TROP-2-expression is associated with poor prognosis in cervical

carcinoma. Recently, TROP-2 was identied as a target protein for treat-

ment of solid tumors using antibody-drug conjugates (ADC). ere are

no details about the expression proles of TROP-2 in vulval cancer (VCX).

Methods: 55 cases of squamous cell carcinomas of the vulva were immu-

nohistochemically analysed for TROP-2 expressio using a H-score (stain-

ing intensity (SI) x percentage of positive stained tumor cells). was score

das negative (0), weak (1), moderate (2) and strong (3). Overall staining

scores were compared to the molecular subtypes of vulval carcinoma,

dening p16+ve/p53wt, p16-ve/p53mut and p16-ve/p53wt VCX. Staining eval-

uation of TROP-2 was blinded to the molecular subtype.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts98

Results:

• All cases were positive for TROP-2 (7 cases +, 31 cases ++ and 17 cases

+++)

• p16+ve/p53wt 16 cases mean value h-score 7,25

• p16-ve/p53mut 31 cases mean value h-score 6,44

• p16-ve/p53wt 2 cases mean value h-score 4

Conclusion: It has been shown that the antibody drug conjugate (ADC)

topoisomerase-1-inhibitor irinotecan, coupled via a linker to a humanised

IgG-1ntibody hRS7 binding to TROP-2 (i.e. sacitumzumab) represents

an eective treatment approach to several carcinoma types. Virtually all

examined VCX showed at least weak staining for TROP-2 within the

tumor cells. So, TROP-2 may represent a potential target for ADC in

vulval cancer. ere are no dierences of TROP-2 expression within the

dierent molecular subtypes of VCX.

Disclosure Statement: e authors declare no conict of interest.

961

3-tiered Molecular Classication of Squamous Cell Vulvar

Cancer: Matched-pair analysis: pre-surgical biopsy versus

radical vulvectomy from the same patient

Lars-Christian Horn1; Mirham Forberger1; Ruth Hiller1; Blake Gilks2;

Naveena Singh2; Lien Hoang2; Bahriye Aktas3; Nadja Dornhöfer3;

Anne Kathrin Höhn1

1Division of Gynecologic Pathology, University of Leipzig, Leipzig, Deutschland

2Vancouver General Hospital and the University of British Columbia, Canada,

Vancouver, Kanada

3Universitätsklinikum Leipzig AöR, Leipzig, Deutschland

Background: Classication of vulvar carcinoma (VCX) into one of

the three molecular subtypes has signicant prognostic and therapeu-

tic impact. An HPV-associated lesion that is p16 positive and p53 wild

type represents improved prognosis compared to other subtypes. A third

(minor) subtype is characterized by normal staining for both markers. It

has been shown that patients with p53-aberrant tumors may benet from

more radical surgical approach. Contrary, HPV-high risk associated VCA

represent better response to chemoradiation.

e aim of this study was to determine the concordance of molecular sub-

typing on diagnostic biopsy compared to the surgical resection specimen.

Methods: 56 matched pairs of VCA diagnostic biopsies (Bx) and its

surgical resection specimens (vulvectomies) were immunohistochemi-

cally evaluated for the immunoexpression of p16 and p53. e molecu-

lar results of the resection specimens were used as “gold standard”. e

examination of the Bx were blinded to the ndings within the resection

specimen.

Results: Matched pair analysis represented a high agreement for molecu-

lar subtyping of VCX comparing diagnostic Bx and the surgical resection

specimen: 93.7% (16/17 cases) for the p16+/p53wt cases; 94.4% (34/36) for

p16-/p53mut. Within the p16- /p53wt VCX there was a lower concordance

(50%; 2/4 cases).

Conclusion: ere is a high concordance rate (~94%) between diagnostic

Bx and surgical resection specimen for the two major types within the

molecular classication of VCX using immunoexpression of p53 (as a sur-

rogate marker for TP53-alterations) and p16 (as a surrogate marker for

HPV high-risk infection).

ese results may represent a valuable nding within the clinical setting

for treatment decisions. By accurate subtyping of the VCX before curative

treatment, the prognostically best treatment approach can be chosen for

the patients.

So, molecular subtyping of VCX within diagnostic biopsies represents a

robust tool to tailor the treatment approach of patients with VCX.

Disclosure Statement: e authors declare no conict of interest.

Head and Neck Cancer

160

Glycoprotein A repetitions predominant (GARP) in oral

cancer - implications for tumor progression

and patient outcomes

Sebastian Blatt1; Emily Trzeciak2; Niklas Zimmer2; Lorenz Schütz1;

Maximilian Krüger1; Nadine Wiesmann-Imilowski1; Peer Kämmerer1;

Daniel Thiem1; Andrea Tüttenberg2; Bilal Al-Nawas1

1Klinik für MKG Chirurgie, Universitätsmedizin Mainz, Mainz, Deutschland

2Hautklinik, Universitätsmedizin Mainz, Mainz, Deutschland

Background: e survival rate of oral cancer remains poor but the under-

lying mechanisms that determine disease progression are not yet fully

understood. Glycoprotein A repetitions predominant (GARP) is overex-

pressed in the suppressive TME and aids in the inhibition of anti-tumor

immune responses. is study aimed to examine the distinctive role of

GARP in oral(pharyngeal) carcinogenesis and to evaluate its potential as

a prognostic biomarker.

Methods: GARP expression in a OPSCC cell line (FaDu) was evaluated

by ow cytometry and western blot. Stably transfected GARP+ cell lines

were developed. Migration, proliferation, suppression, and tumor sphe-

roid growth assay were performed. Drug resistance to cisplatin and radi-

ation was tested. Retroactive analyses of GARP mRNA levels in tumor

tissue were performed. GARP expression in tumor tissue was analyzed via

immunohistochemistry. sGARP levels were quantied in patient serum.

Result: High levels of GARP were shown in OSCC tumor tissue and the

OPSCC cell line, FaDu. Stably transfected GARP+ FaDu cells were tested

for enhanced suppressive capacity. Retroactive analysis of GARP mRNA

levels did not correlate with patient overall survival. GARP protein lev-

els were linked to tumor recurrence and overall survival. Cancer patients

showed higher levels of sGARP than healthy donors, but sGARP levels did

not correlate with TNM status.

Discussion: GARP plays a critical role in the production and release of

active TGF-β. is way, GARP orchestrates tumor immunosuppressive

strategies, leading to an inhibitory TME and thereby supporting tumor

progression. e presented data conrms a vital role of GARP in oral

carcinogenesis.

Conclusion: Our results indicate for the rst time that GARP plays a sig-

nicant role in oral carcinogenesis.

Disclosure Statement: e authors declare no conict of interest.

268

The impact of demographic change on the survival of head

and neck cancer patients in Germany at national

and county level

Julius Vahl1; Gabriele Nagel2; Ayla Grages1; Matthias Brand1;

Adrian von Witzleben1; Michael Sonntag1; Marie-Nicole Theodoraki1,3;

Jens Greve1; Tsima Aboukors1; Michael Denkinger4; Dhayana Dallmeier4;

Christian Idel5; Stephan Stilgenbauer6; Thomas Homann1; Simon Laban1

1Klinik für Hals-, Nasen- und Ohrenheilkunde am Universitätsklinikum Ulm, Ulm,

Deutschland

2Institut für Epidemiologie und Medizinische Biometrie Ulm, Ulm, Deutschland

3Klinik für Hals-, Nasen- und Ohrenheilkunde am Klinikum rechts der Isar der

Technischen Universität München, München, Deutschland

4Agaplesion Bethesda Klinik Ulm, Ulm, Deutschland

5Klinik für Hals-, Nasen- und Ohrenheilkunde am Universitätsklinikum

Schleswig-Holstein, Campus Lübeck, Lübeck, Deutschland

6Universitätsklinikum Ulm Klinik für Innere Medizin III, Ulm, Deutschland

Background: e German population is aging. In addition, there are

shiing population structures in geographic terms between urban and

rural areas as well as between East and West. is demographic change

could have an impact on the survival of head and neck cancer patients

(HNCP).

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 99

Methods: We performed a nationwide analysis on the incidence and the

association of epidemiological indicators with survival. Between 2002 and

2017 data of 212920 HNCP from the Center for Cancer Registry Data and

the Federal Statistical Oce were collected in this context.

Result: e prevalence of HNCP in patients older than 70 years rose from

20.6% in 2002 to 34.4% in 2017, especially in urban areas. Furthermore,

we observed a faster increase in mean age among our patients compared

to the normal population (slope coecient: 0.29 vs. 0.20; p < 0.001), again

notably in urban areas. In East Germany median overall survival was

lower than in West Germany: 47 vs. 60 months (p < 0.0001). In addition,

median survival of HNCP in rural areas was lower than in urban areas in

East but not in West Germany (42 vs. 54 months; p < 0.0001). is dis-

parity was associated with a higher proportion of men in East Germany

(men/women: 4.4 vs. 3.1; p < 0.0001), with a lower median age (61 vs. 63

years; p < 0.001) and with higher travel distances to medical centers (69.4

vs. 30.6 km; p < 0.0001).

Discussion: e current demographic changes are associated with a

higher prevalence of HNCP in older patients. Regardless of reunication,

a HNCP related survival disadvantage for patients in East Germany, par-

ticularly in rural areas, still becomes apparent.

Conclusion: Place of residence contributes to survival outcome of HNCP

in Germany. Access to specialized care and socioeconomic factors could

be improved, especially in East Germany.

Disclosure Statement: e authors declare no project-related conict of interest.

306

Information is the Key: First Glimpse into the Prospective

NAVIGATORR Trial

Sebastian Regnery1; Lukas Bauer1; Reinald Kühle2; Jennifer Fuchs2;

Julius Moratin2; Florian Stritzke1; Philipp Schröter1; Katharina Weusthof1;

Maximilian Deng1; Tanja Eichkorn1; Sebastian Adeberg3; Jürgen

Homann2; Jürgen Peter Debus1; Christian Freudlsperger2; Thomas Held1

1Universitätsklinikum Heidelberg, Abteilung für RadioOnkologie und

Strahlentherapie, Heidelberg, Deutschland

2Universitätsklinikum Heidelberg, Klinik und Poliklinik für Mund-, Kiefer- und

Gesichtschirurgie, Heidelberg, Deutschland

3Universitätsklinikum Gießen und Marburg (UKGM) | Standort Marburg,

Abteilung für Strahlentherapie, Marburg, Deutschland

Background: Head-and-neck cancers (HNC) are frequently detected in

locally-advanced stages. Despite surgery and postoperative radiotherapy

(PORT), many patients experience tumor progression. Information loss

between disciplines seems an Achilles heel of current approaches. Hence,

we investigate how an interdisciplinary workow based on modern imag-

ing with intraoperative navigation impacts treatment outcomes.

Methods: NAVIGATORR is a prospective clinical trial that enrolls 60

patients with locally-advanced HNC of the skull base. Patients undergo

tumor resection with an intraoperative optical navigation system

(Brainlab, Munich, Germany). Resection is planned based on state-of-the

art CT and MRI by an interdisciplinary team (surgeons, radiologists, radi-

ation oncologists). Surgeons take standardized resection margin biopsies

(MARBs). MARBs are localized on the imaging, and pathology results are

annotated. en, the radiation oncologists import the intraoperative data

into their radiation planning soware to individualize PORT.

Result: So far, six patients underwent navigation-based tumor resection

and four patients received PORT. On average, 8.7 MARBs were taken

(range: 6 - 14), and all were successfully annotated and transferred to the

radiation planning soware. e orientation of positive margins in the

main specimen and MARBs correlated in ve cases. One patient showed

clear margins in the main specimen but one positive MARB, which led

to re-resection (nally R0). e high dose planning target volumes (66

– 70 Gy) acc. to DAHANCA guidelines correctly encompassed positive

MARBs in all cases.

Discussion: Our early experience supports the feasibility of our inter-

disciplinary workow and demonstrates the potential benets of a data

round-trip. Still, NAVIGATORR is a work in progress. We are looking

forward to more extensive and mature data.

Conclusion: Combination of modern imaging, intraoperative naviga-

tion and interdisciplinary teamwork can enhance oncological safe tumor

resection and PORT target volumes.

Disclosure Statement: e authors declare the following: RK and CF previously

acted as advisors of Brainlab, Germany.

325

HPV-16 positive HNSCC cells exhibit a pronounced

oxygen dependence and reduced glycolytic capacity

forenergyproduction

Norio Kasahara1; Jennifer Stephania San Lucas Zambrano2;

Hytham Al Rabadi1; Andreas Ne3; Boris Alexander Stuck2; Ulrike Theiß4;

Michael Bette5; Wolfgang Meißner6; Robert Mandic2

1Klinik für Hals-, Nasen- und Ohrenheilkunde, Kopf- und Hals-Chirurgie,

Universitätsklinikum Gießen und Marburg GmbH, Philipps-Universität

Marburg, Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie,

Universitätsklinikum Gießen und Marburg GmbH, Philipps-Universität Marburg,

Marburg, Deutschland

2Klinik für Hals-, Nasen- und Ohrenheilkunde, Kopf- und Hals-Chirurgie,

Universitätsklinikum Gießen und Marburg GmbH, Philipps-Universität Marburg,

Marburg, Deutschland

3Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie,

Universitätsklinikum Gießen und Marburg GmbH, Philipps-Universität Marburg,

Marburg, Deutschland

4Klinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Gießen

und Marburg GmbH, Philipps-Universität Marburg, Marburg, Deutschland

5Institut für Anatomie und Zellbiologie, Philipps-Universität Marburg, Marburg,

Deutschland

6Institut für Humangenetik, Philipps-Universität Marburg, Marburg,

Deutschland

Background: e most important risk factors for the development of

head and neck squamous cell carcinomas (HNSCC) are tobacco and

alcohol consumption as well as infection with human papilloma viruses

(HPV). It has been known for many years that, compared with normal

cells, cancer cells, even in the presence of oxygen, increasingly use gly-

colysis for energy production, which is known as the Warburg eect or

aerobe glycolysis. In our study, we looked into the metabolic response of

HPVpos and HPVneg HNSCC cell lines aiming to uncover weak points for

therapeutic targeting.

Methods: Six HNSCC cell lines, 3 HPVneg and 3 HPVpos, were investigated

regarding their metabolic response by measuring the oxygen consump-

tion rate (OCR) and the extracellular acidication rate (ECAR) using the

Seahorse XFe96 Extracellular Flux Analyzer.

Results: HPVpos HNSCC cells compared with HPVneg HNSCC cells exhib-

ited signicantly higher values for i) ATP production by oxidative phos-

phorylation (OXPHOS), ii) basal respiration and iii) maximal respiratory

capacity. In HPVpos HNSCC cells, ATP production was signicantly more

derived from OXPHOS and signicantly less from glycolysis (GLYCO)

compared with HPVneg HNSCC.

Discussion: Inhibiting the glycolytic pathway could help radiosensitizing

not only HPVpos but in particular HPVneg HNSCC. is approach was also

reported by Fleming and colleagues, who used an inhibitor of the mono-

carboxylic acid transporter-1 in their study (Fleming et al. Br J Cancer.

2019 Feb;120(3):356-367).

Conclusions: e observations made in this study could explain clini-

cal observations in which patients with HPV-positive HNSCC typically

present with cervical lymph node metastases that are centrally necrotic,

since HPV-positive HNSCC in central hypoxic areas of the tumor possibly

can only poorly maintain energy production via glycolysis. Current work

of our group is investigating the inuence of photon- and particle based

therapies, in the presence or absence of metabolic inhibitors, on the radio-

sensitivity of HNSCC cells.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts100

366

Increasing outreach and awareness of head and neck cancer

by performing an o-site activity diary accompanying a

regional activity program (“UTA – Unterwegs trotz alledem”)

Sabine Felser1; Gunthard Kissinger2; Ute Kalinowski3; Ernst Klar4;

Christian Junghanß1; Sabina Ulbricht5

1Universitätsmedizin Rostock, Klinik III - Hämatologie, Onkologie,

Palliativmedizin, Rostock, Deutschland

2Selbsthilfenetzwerk Kopf-Hals-M.U.N.D.-Krebs e. V., Bonn, Deutschland

3Rostocker Selbsthilfegruppe für Tumor im Mund, Kiefer, Gesicht und Hals.,

Rostock, Deutschland

4Krebsgesellschaft Mecklenburg-Vorpommern e. V., Rostock, Deutschland

5Universitätsmedizin Greifswald, Institut für Community Medicine, Abt.

Präventionsforschung und Sozialmedizin, Greifswald, Deutschland

Background: “UTA - Unterwegs trotz alledem” was an information

and activity program, organized by the self-help network Kopf-Hals-

M.U.N.D.-Krebs e. V. It was piloted in Mecklenburg-Vorpommern (MV)

in June 2023. e aim was to increase the awareness of the general pop-

ulation with regard to causes and consequences of head and neck cancer

(HNC). e information campaign throughout the month was accompa-

nied by several local physical activities. ese were organized in dierent

areas of MV to promote joint activities for adults with and without can-

cer. To gain insights into the outreach of UTA, an o-site activity diary

(osAd) was developed and sent out on request. e outreach of UTA will

be described by using data from those who have returned osAd.

Methods: e osAd was designed for recording daily physical activities

during the month of action. e introduction section included questions

about sex, age, educational level (≤ 10 or > 10 years), postal zip code, rea-

sons for participation, and how they became aware of UTA. Participants

were asked to return the osAd in July 2023.

Result: In total, 102 osAd were sent out prior to the start of UTA and

54 were returned. is sample consists of individuals from nine federal

German states and Austria (75% woman, 63 ± 9 year, 70% > 10 years

of schooling). A proportion of 74% (n = 39) was suering from cancer,

mostly HNC (n = 28) Reasons for participation were e. g. “to support

research” (n = 12), “curiosity/overview of one’s activities/tness” (n = 12),

or “as a stimulus to become more physically active” (n = 5). A proportion

of 63% became aware of UTA through self-help groups, 6% through social

media, and 4% through physicians.

Discussion: e osAd, as add-on to a local physical activity program,

seems to be benecial to reach individuals from other regions for partic-

ipation too. Self-help groups are important players in the promotion of a

program like UTA - even to non-HNC suerers.

Conclusion: In order to increase the reach, campaigns such as UTA

should be promoted earlier using more diverse communication channels.

Disclosure Statement: e authors declare no conict of interest.

411

Targeted therapy in salivary gland cancer: Prevalence of

actionable molecular alterations in a German tertiary referral

center patient cohort

Maximilian Linxweiler1; Sandrina Körner1; Felix Leon Braun1;

Moritz Knebel1; Lukas Alexander Brust1; Silke Wemmert1;

Mathias Wagner2; Bernhard Schick1; Jan Philipp Kühn1

1Saarland University Medical Center, Department of Otorhinolaryngology, Head

and Neck Surgery, Homburg/Saar, Deutschland

2Saarland University Medical Center, Department of General and Surgical

Pathology, Homburg/Saar, Deutschland

Background: Salivary gland carcinomas (SGC) are a heterogeneous group

of malignancies, with 24 subtypes dened by the WHO. e standard of

therapy is surgical resection, with adjuvant (chemo)radiotherapy in most

cases. However, disease recurrence or metastasis is common and no active

systemic therapies are currently available for RM-SGC resulting in a

5-year survival rate of only 20%.

Methods: 55 SGC patients with 8 dierent histological tumor subtypes

were included in this study. FFPE tissue samples were used for immu-

nohistochemistry targeting HER2/neu, androgen receptor (AR), PD-L1,

EGFR, panTRK, and TROP2. Immunoreactive scores (IRS) were assessed

by four independent examiners and correlated with clinical and histo-

pathological data.

Result: e overall prevalence of druggable molecular alterations dened

as IRS value ≥9 in at least one of the analyzed targets was 54,4%% with

the highest percentage in adenocarcinomas (87,5%) and lowest percent-

age in acinic cell carcinomas (10%). EGFR overexpression proved to be

the most common alteration (32,7% of cases) followed by overexpression

of TROP2 (27,3%), AR (19,9%), HER2/neu (5,5%), PD-L1 (1,8%), and

panTRK (1,8%).

Discussion: Our data indicate that targeted therapy using e.g. trastu-

zumab deruxtecan, bicalutamide, pembrolizumab, cetuximab, entrectinib

or sacituzumab govitecan might be a promising option for a relevant sub-

set of SGC patients. However, evidence from clinical studies regarding

response rates to these therapies remains sparse, which underlines the

need of multicenter clinical trials.

Conclusion: While response to systemic therapies in RM-SGC are clearly

limited molecular testing of the abovementioned targets can oer poten-

tial therapeutic options especially in RM-SGC cases not suitable for sal-

vage surgery.

Disclosure Statement: e authors declare no conict of interest.

424

Feasibility of an individual home training program for head

and neck cancer patients – results of the multicenter OSHO

#94 study

Sabine Felser1; Christian Junghanß1; Julia Rogahn1; Lars Arne Bonke1;

Daniel Fabian Strüder2; Jana Stolle3; Susann Schulze3; Markus Blaurock4;

Michael Schröder5; Sabina Ulbricht6; Christina Große-Thie1

1Rostock University Medical Center, Department of Medicine Clinic III,

Hematology, Oncology, Palliative Medicine, Rostock, Deutschland

2Rostock University Medical Center, Department of Otorhinolaryngology, Head

and Neck Surgery, Rostock, Deutschland

3University Hospital Halle, Department of Hematology and Oncology, Halle

(Saale), Deutschland

4University Medicine Greifswald, Department of Otorhinolaryngology, Head

and Neck Surgery, Greifswald, Deutschland

5University Medicine Greifswald, Department of Trauma, Reconstructive Surgery

and Rehabilitation Medicine, Greifswald, Deutschland

6University Medicine Greifswald, Institute for Community Medicine, Department

of Social Medicine and Prevention, Greifswald, Deutschland

Background: Physical activity may be a key factor in rehabilitation of

patients with head and neck cancer (pwHNC). e East German Study

Group for Hematology and Oncology (OSHO) is conducting a study to

evaluate the eects of a 12-week home-based, unsupervised, individual-

ized training program on quality of life (QoL, primary endpoint; OSHO

#94)1. Here, we present the feasibility results.

Methods: A multicenter, single-arm, prospective, longitudinal study

is conducted by the OSHO (DRKS00023883). Demographic and clin-

ical data are collected. Adherence to the training (e. g., frequency,

duration) as well as adverse events in terms of this are documented

by patients in a training diary and queried weekly by a therapist. The

program consists of an individualized training (selected exercises for

mobilization, coordination, strengthening, stretching) of three units

per week á 15-30 min and should be supplemented by at least 2 units

of endurance training á 30 min. We verified the hypothesis that the

proportion of pwHNC who dropped-out of the training program is

lower than 30%. QoL is assessed using EORTC-QLQ-C30, before and

after the training program.

Result: During 01/21 to 02/23, a number of 25 pwHNC (52% male, 66 ±

13 years, 92% complete remission) were included. Due to surgery or sus-

pected relapse three patients (12%) dropped out. On average, those who

completed the training program exercised 7 ± 3 times per week. ree

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 101

adverse events (AE; pain) were reported. QoL was higher aer the train-

ing program before the start (64 ± 16 vs. 72 ± 14, p = 0.042).

Discussion: Home-based training in pwHNC seems to be feasible. e

program was completed by 88% and the reporting of AEs were low. e

majority of pwHNC performed more training sessions as required by

protocol.

Conclusion: e feasibility of the study protocol was conrmed. Based on

these ndings the study will proceed recruiting.

Indication of source: (Optional, bitte löschen Sie diesen Absatz, wenn Sie keine

Quellenangaben haben):

1 Felser S et al., ONCOLOGY RESEARCH AND TREATMENT 2020; 43

(SUPPL 4): 134.

Disclosure Statement: e authors declare no conict of interest.

436

Quality of outcome in oral cancer patients - First results of

a perioperative evaluation of patient-specic inuencing

factors with special regard to mental and physical strength

Juliane Kröplin1; Jil-Charlot Reppenhagen1; Anke Hirsemann2; Jan Liese1;

Bernhard Frerich1

1Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie, Rostock,

Deutschland

2Onkologisches Zentrum, Rostock, Deutschland

Background: e aim of the present study is the perioperative analysis

of patient-specic factors inuencing the quality of outcome in head and

neck tumour surgery under university centre conditions.

Methods: Patients with oral squamosa cell carcinomas and indication for

surgical resection were included. General and disease-related data as well

as patient-specic resilience (RS-11 questionnaire) were collected. e

general quality of life was analysed in terms of importance and satisfaction

using the 9 items family/friends, sports activities, participation in culture,

professional perspectives, sexuality, enjoyable food, external appearance,

social recognition and independence on a Likert scale. e data collection

took place pre- and postoperatively during the inpatient stay.

Result: N=17 patients with squamous cell carcinoma of the oral cavity

were analysed (male: n=15, female n=3). e rate of R0 resections was

100%. N=7 of all patients was tracheotomised postop and n=4 patients

at the time of discharge. N=0 patients conrmed psycho(onco)logical

support preop (postop: n=12). Sports activities/physiotherapy was pro-

vided to n=0 patients preop (postop: n=12). e mean postop pain per-

ception was 3/10. e RS score decreased signicantly postoperatively

(mean: preop 5.3/7, postop: 4.1/7; p<0.001). A signicant loss of satisfac-

tion was seen in the areas of enjoyable food (p=0.002), social recognition

(p=0.029), external appearance (p=0.011) and independence (p=0.003).

Discussion: Supportive therapy measures to promote the physical and

mental tness of oral cancer patients are part of inpatient care at our

clinic. However, there is no structured monitoring of these therapies that

can be measured and compared.

Conclusion: Structured and measurable programmes to increase mental

and physical tness in both prehospital and inpatient care could lead to

an improvement in the quality of outcome. is might also improve the

comparability of treatment strategies and postoperative courses.

Disclosure Statement: e authors declare no conict of interest.

447

HPV-negative status has a greater impact on worse overall

survival than the smoking status in oropharyngeal cancer - a

population-based analysis in Germany from 2018 to 2020

Mussab Kouka1; Laura Gerlach1; Jens Büntzel2; Holger Kaftan3;

Daniel Böger4; Andreas Müller5; Thomas Ernst6; Orlando Guntinas-Lichius1

1Uniklinikum Jena/Klinik für Hals-, Nasen- und Ohrenheilkunde, Jena,

Deutschland

2Südharz Klinikum Nordhausen, Nordhausen, Deutschland

3Hals-, Nasen- und Ohrenheilkunde, Plastische Operationen | Helios Klinikum

Erfurt, Erfurt, Deutschland

4SRH Zentralklinikum Suhl gGmbH Klinik für Hals-, Nasen-, Ohrenheilkunde

-Plastische Operationen-, Suhl, Deutschland

5SRH Wald-Klinikum Gera, Gera, Deutschland

6UniversitätsTumorCentrum Jena am Universitätsklinikum Jena, Jena,

Deutschland

Background: e aim was to evaluate the interaction of human papilloma-

virus (HPV), smoking and alcohol status on oropharyngeal squamous cell

carcinoma (OPSCC) on overall survival (OS) in population-based setting.

Methods: In this retrospective cohort study, data of 498 patients with

OPSCC (mean age: 62.5 years; 77% male) from 2018 and 2020 were

included. Binary logistic regression analysis and Cox multivariable regres-

sion analysis were performed.

Result: OPSCC were 37.3% HPV-positive (+; among them 31.2% smok-

ers; mean incidence: 2.91/100,000 population) and 57.8% HPV-negative

(-; 63.5% smokers; mean incidence: 4.50/100,000 population). Median

follow-up was 20 months. HPV+ patients had signicantly better OS

than HPV- patients (HPV+: 2-year OS: 90.9%; HPV-: 2-year OS: 73.6%;

p < 0.001). In binary logistic regression analysis, smokers showed a 4.5

increased odds ratio (OR) of being tested HPV- than for nonsmokers (OR:

4.5; 95% CI: 2.76-7.35; p < 0.001). In multivariable analysis, HPV- patients

(hazard ratio (HR) = 4.5; 95% condence interval (CI): 2.4 - 8.6), patients

with a higher N classication (N2: HR = 3.3; 95% CI: 1.71 – 6.20; N3: HR

= 3.6; 95% CI: 1.75 -7.31) and with a higher cancer staging (III: HR = 5.7;

95% CI: 1.8 - 17.6; IV: HR = 19.3; 95% CI: 6.3 -57.3) had an increased haz-

ard of death (all p < 0.05). Smoking and alcohol habits had no signicant

independent eect on OS (smokers: HR = 1.1; 95% CI: 0.65 - 1.83; IV:

alcoholics: HR = 1.4; 95% CI: 0.87 - 2.3; both p > 0.05)

Discussion: Worldwide studies have reported an increase of HPV+

OPSCC. e result is that HPV+ has overtaken HPV- OPSCC in many

countries. In contrast, HPV+ OPSCC still is a minority in uringia, espe-

cially HPV+ OPSCC in non-smokers. Classical risk factors continue to

dominate and have greatest impact on OS.

Conclusion: It is more important to optimize therapeutic strategies for

HPV- OPSCC than to discuss de-escalation strategies for HPV+ patients.

Disclosure Statement: e authors declare no conict of interest.

449

Analysis of the tumor immune microenvironment of

advanced, non-adenoid cystic salivary gland cancer

Benjamin von der Emde1; Erika Zuljan2; Eric Blanc2; Iris Piwonski3;

Frederick Klauschen3; Ingeborg Tinhofer-Keilholz4; Andreas Mock5;

Peter Horak6; Ulrich Keller1; Konrad Klinghammer1; Stefan Fröhling6;

Sebastian Ochsenreither7; Ulrich Keilholz7; Dieter Beule2; Damian Rieke1

1Charité -CBF Klinik m.S. Hämatologie, Onkologie und Tumorimmunologie,

Berlin, Deutschland

2BIH, Berlin, Deutschland

3Charité - Institut für Pathologie, Berlin, Deutschland

4Charité - Klinik für Radioonkologie und Strahlentherapie, Berlin, Deutschland

5Uni München, München, Deutschland

6NCT Heidelberg, Heidelberg, Deutschland

7Charité Comprehensive Cancer Center, Berlin, Deutschland

Background: Salivary gland cancers (SGC) are a group of rare malig-

nancies. Systematic data on ecacy of immune checkpoint inhibition are

lacking for the heterogeneous group of non-adenoid cystic carcinomas.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts102

We analyzed the tumor immune microenvironment, molecular signa-

tures, and clinical outcomes of advanced non-adenoid cystic salivary

gland cancer to identify novel therapeutic strategies.

Methods: Cases of recurrent and/or metastatic non-ACC SGC from the

DKTK MASTER program were included in the analysis. Whole exome/

whole genome and transcriptome sequencing as well as clinical data were

analyzed.

Result: 42 cases of advanced SGC were identied (8 adenocarcinoma

NOS, 7 mucoepidermoid carcinoma, 6 basal cell carcinoma, 6 salivary

duct carcinoma, 3 acinic cell carcinoma, 3 carcinoma ex pleomorphic ade-

noma, 2 carcinosarcoma, 7 other entities). An inamed tumor immune

microenvironment in transcriptome data was identied in 36 percent

of the samples. e median tumor mutational burden (TMB) was 2.42

(0.033 – 8.5). No association was found between tumor inammation

and TMB or prior therapies. Immune checkpoint expression, including

PD-1, TIM-3, CTLA-4, LAG-3 and TIGIT, was identied in a subgroup

of patients. Response data for 7 patients receiving immune checkpoint

inhibition were available, one of which achieved clinical benet in two

treatment regimens, receiving Nivolumab and Ipilimumab, achieving sta-

ble disease for 46 and 10 months respectively. e patient’s tumor immune

microenvironment was described as T-cell predominant.

Discussion: An inamed tumor immune microenvironment and immune

checkpoint expression was identied in patient subgroups and could

guide novel immune therapy strategies.

Conclusion: Comprehensive molecular characterization should be con-

sidered for treatment stratication in these rare tumor types.

Disclosure Statement: DR has received consultant and/or advisory board and/or

speaker fees from Roche, Bayer, Bristol-Myers Squibb and Lilly

Disclosure Statement: e authors declare the following: DR has received

consultant and/or advisory board and/or speaker fees from Roche, Bayer, Bristol-

Myers Squibb and Lilly

513

Correlation between the mean dose of the parotid glands

with xerostomia and HRQoL in patients withhead and neck

cancer– an unicentre cross sectional study

Anke Breitling; Dirk Vordermark; Daniel Medenwald

Universitätsklinik für Strahlentherapie der Universitätsmedizin Halle/Saale,

Halle/Saale, Deutschland

Background: Intensity-modulated radiotherapy (IMRT) is a well established

option in the primary treatment of head and neck cancer. e close proxim-

ity of the parotid glands to the tumor and lymphonodes induces accidental

irradiation which causes acute or late toxicities such as salivary hypofunc-

tion, which results in xerostomia or sticky saliva. e aim of this study was to

detect the subjective perception of patients concerning health-related quality

of life (HRQoL) one year aer the treatment with radiotherapy either alone

or in combination with surgery, chemotherapy and/or cetuximab.

Methods: is study included 56 patients with cancer of the head and

neck. We used the EORTC QLQ-C30, EORTC QLQ-OH15, Groningen

Radiotherapy-Induced Xerostomia Questionnaire – GRIX to assess qual-

ity of life. In addition, we collected patient-, tumor- and therapy charac-

teristics and furthermore analyzed the CTCAE-Score for xerostomia.

Result: A higher burden of symptoms goes along with a reduced health-

related quality of life. We found a regression coecient ß = -0,184 (95% CI

0,356 and -0,012) for „GRIX xerostomia night“ and global quality of life.

Higher physician-reported grades of a dry mouth were associated with

higher scores (higher burden of the symptoms) in patient-reported xero-

stomia concerning day, total score and OH15 xerostomia. e spearman

correlation revealed medium-strength correlation between physician-

and patient-reported xerostomia.

Discussion: e grade of xerostomia, assessed by CTCAE seems to be a

poor predictor for HRQoL. ere is a need to implement patient-reported

burden within international classication.

Conclusion: Mouth-associated long-term side eects aect the health-

related quality of life one year aer treatment of head and neck cancer.

By analyzing in a dierentiated way when a specic mouth-associated

symptom deteriorates the patient-described quality of life, it is possible to

establish new strategies of supporting those patients.

Disclosure Statement: e authors declare no conict of interest.

573

Feasibility study OncSaliva – non-invasive specimen for the

detection of head and neck cancer via epigenetic markers

Anna-Bawany Hums1; Mussab Kouka2; Lars Jansen3; Matthias Dürst3;

Alfred Hansel1; Martina Schmitz1; Orlando Guntinas-Lichius2

1oncgnostics GmbH, Jena, Deutschland

2Department of Otorhinolaryngology, Jena University Hospital,

Jena, Deutschland

3Department of Gynecology, Jena University Hospital, Jena, Deutschland

Background: Head and neck squamous cell carcinoma (HNSCC) are

mainly diagnosed at advanced tumor stage aer the onset of symptoms.

Timely detection would improve the options for successful treatment.

Here, we investigate ve tumor-specic DNA methylation markers in the

current OncSaliva study to determine the clinical performance in non-in-

vasive specimen, such as saliva samples.

Methods: DNA methylation markers ZNF671, ZNF833, ZIC1, PAX6-1,

HOXA9 and bisulte-specic reference Beta-Actin were analyzed using

fresh-frozen tissue, saliva and swabs from HNSCC patients and controls.

Samples were bisulte-converted prior to methylation-specic multiplex

qPCR. Study goal is to include 100 controls and 100 HNSCC patients, the

latter with two-year follow-up examination.

Results: Up until now we analyzed fresh-frozen tissue and saliva from

51 HNSCC patients and 33 controls in the OncSaliva study. DNA meth-

ylation markers showed 75% sensitivity and 100% specicity, if three of

ve markers were required to test positive in tissue. Single-marker detec-

tion oered up to 83% sensitivity with 97% specicity. In saliva samples

the best single marker resulted in 71% sensitivity and 82% specicity. If

three out of ve markers were positive in saliva, 63% sensitivity and 91%

specicity could be reached. Comparison of tissue and saliva sample pairs

yielded 49% to 78% agreement for the HNSCC group and 73% to 100%

agreement in the control group. Data from swab samples and individual

patient follow-ups will be presented at the congress.

Conclusion: Preliminary results from marker validation and from recent

patient samples support our study hypothesis to robustly detect HNSCC

markers in both, tissue and saliva. Utilization of saliva samples for can-

cer-specic diagnostic assays based on epigenetic markers will be useful in

in vitro diagnostics aiming at secondary and tertiary prevention.

Disclosure Statement: e authors declare the following: Forschungsstudie

zwischen Uniklinikum Jena und oncgnostics GmbH & A.-B. Hums is employed as

an R&D scientist at oncgnostics GmbH.

597

Hybrid vascular graft prosthesis for vascular reconstruction

of the internal carotid artery near the skullbase after

radical excision of a very rare malignant Glomus-caroticum-

paraganglioma

Frank Meyer1; Christoph Arens2; Udo Barth3; Dörthe Jechorek4;

Zuhir Halloul3

1Dept. of General, Abdominal, Vascular and Transplant Surgery; University

Hospital, Magdeburg, Deutschland

2Dept. of Otorhinolaryngology, University Hospital (former aliation),

Magdeburg, Deutschland

3Division of Vascular Surgery; Dept. of General, Abdominal, Vascular and

Transplant Surgery; University Hospital, Magdeburg, Deutschland

4Institute of Pathology, University Hospital, Magdeburg, Deutschland

Background: Neck tumor (Tu) lesions are challenging regarding the

diagnostic & therapeutic management, in particular, in case of malignant

Tu growth & near relevant vessels to achieve R0 resection status for best

prognosis.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 103

Aim: To present the successful outcome of a demanding interdisciplinary

surgical approach (otorhinolaryngology & vascular surgery) because of a

necessary surgical re-intervention due to malignant Tu growth (detected

in the histopathologic investigation of the rst specimen) including vas-

cular resection using a hybrid gra for vascular reconstruction of the

internal carotid artery near the skullbase.

Method: Scientic case report.

Result (case description): A 38-years old male patient underwent diag-

nostics (MRA & DSA) to clarify diagnosis of a Tu lesion at the right neck,

which was preoperatively embolized & subsequently resected including

vascular reconstruction using a prosthetic interponate (7 cm; W.L. Gore

GmbH, Putzbrunn, Germany) between common & internal carotid

arteries - histology: malignant paraganglioma of 40 mm in diameter with

cancerous haemangiosis et lymphangiosis demonstrating lymph node

metastasis & prompting to re-operation (neck dissection [level II, III,

IV, V] followed by novel vascular reconstruction using GORE® Hybrid

Vascular Gra prosthetic stent [W.L. Gore GmbH] as interponate because

of the short extracranial stump of the distal internal carotid artery near

the skullbase & to limit clamping time). Early postoperative outcome

revealed no complications; aer 12 months, there were no signs & symp-

toms of recurrent Tu growth.

Conclusion: Extended resections – if necessary including vascular

(arterial) segments aim at achieving R0 classication as shown in this

extremely rare & usually challenging malignant Tu lesion. Hybrid vascular

prostheses are suitable for time-saving vascular reconstruction to repro-

vide sucient blood supply.

Disclosure Statement: e authors declare no conict of interest.

618

Prognostic value of tumor budding in salivary gland

carcinoma

Valentin Burkhardt1; Gian Kayser2; Christoph Becker1

1Universitätsklinikum Freiburg/HNO, Freiburg, Deutschland

2Gemeinschaftspraxis für Pathologie Freiburg, Freiburg im Breisgau,

Deutschland

Background: A high tumor budding score in low-grade major salivary

gland carcinoma (MSGC) seems to lead to higher T and N stages, recur-

rences and an impaired disease-free survival. Treatment of low-grade

(MSGC) consists regularly of sole surgical therapy of the salivary gland

without elective neck dissection in T1/2 carcinomas or adjuvant radiation

therapy (RT).

Methods: We analyzed retrospectively data of 71 patients with either low-

grade MSGC with a high tumor budding score and high grade MSGC

from 2003 to 2017 in a single center study. Pathological risk factors and

TNM classication were reviewed for each case. All HE-stained histologi-

cal specimen were reviewed and tumor budding was determined.

Result: Kaplan-Meier analysis of overall survival showed 84.7 months

(CI: 55.8;113.6) in the low grade/high tumor budding group and 56.2

months (CI: 40.6;71.8) in the high grade group (log-rank p<0,05). Cox

regression revealed a signicant inuence of the age (p<0.05), whereas the

grading had no signicant inuence (p>0.05). e disease-free survival

accounts for 75.5 months (CI: 54.7;96.2) in the low grade group and 78.5

months (CI: 55.1;101.9) in the high grade group (log-rank p<0.05). Cox

regression showed no statistically signicant inuence of age or grading

(bothp>0.05).

Discussion: e current debate about treating MSGCs with less extended

surgical procedures holds benets and risks for the patients. Whereas

therapy of high-grade MSGC includes surgical resection, elective neck

dissection as well as adjuvant RT, therapy of low-grade MSGC without

nodal metastasis has an excellent outcome in terms of OS and DFS. Tumor

budding might function as an additional prognostic factor in low-grade

MSGC as it seems to be associated with higher recurrence rates compared

to high grade salivary gland carcinomas.

Conclusion: Tumor budding might help to reduce therapy reduction in

low-grade MSGC with a higher risk of occult metastasis and locoregional

recurrence to optimize therapy and outcome.

Disclosure Statement: e authors declare no conict of interest.

808

Vitamin D receptor as a non-invasive predictor for laryngeal

squamous cell carcinoma

Olaf Wendler1; Marlen Haderlein2; Michael Koch1; Matti Sievert1;

Matthias Balk1; Robin Rupp1; Antoniu-Oreste Gostian1; Abbas Agaimy3;

Rainer Fietkau2; Heinrich Iro1; Sarina Müller1

1Department of Otolaryngology, Head and Neck Surgery, Universitätsklinikum

Erlangen, Erlangen, Deutschland

2Department of Radiation Oncology, Universitätsklinikum Erlangen, Erlangen,

Deutschland

3Department of Pathology, Universitätsklinikum Erlangen, Erlangen,

Deutschland

Purpose: e vitamin D receptor (VDR) is responsible for the expression

of numerous genes including cell proliferation and dierentiation. Along

with vitamin D itself it is subject of clinically driven research. However,

its role as non-invasive marker for laryngeal squamous cell carcinoma

(LSCC) has never been investigated. erefore, the objective of this study

was to analyze the potential of VDR as non-invasive serum marker for

LSCC.

Methods: IRB approved study of n=49 controls and n=75 LSCC who

underwent a panendoscopy for tumor staging, a biopsy and blood sam-

pling. According to the TNM staging system 8th version dierent tumor

sizes of LSCC (T1-4a) were included. VDR was analyzed in tissue using

Immunohistochemistry (IHC) and Immunouorescence (IF). In the fol-

lowing, results were validated using Western Blots (WB). Finally, serum

VDR was analyzed using ELISA.

Results: VDR was signicantly overexpressed in tissue of LSCC patients as

shown in WB (p=0.008). Moreover, VDR was signicantly overexpressed

in serum of LSCC patients with higher serum levels in larger tumor sizes

(e.g. T1/2 p<0.045, T3/4 p<0.001).

Discussion and conclusions: VDR showed a signicant overexpression

in tissue as well as in serum of LSCC patients in all tumor sizes. For this

reason, VDR may be a potential non-invasive predictor for advanced size

LSCC but more importantly also for early stage LSCC. Further studies are

needed to investigate the clinical meaningfulness.

Disclosure Statement: e authors declare no conict of interest.

831

Rad51 in breast cancer brain metastases

Johanna Schaser; Falko Schwarz; Christian Senft; Peter Baumgarten;

Diana Freitag

Universitätsklinikum Jena, Klinik für Neurochirurgie, Jena, Deutschland

Background: Breast cancer (BC) is the most common form of cancer in

women. Breast cancer brain metastases (BCBM) are late complications

with poor prognosis. e DNA repair gene Rad51 is associated with

aggressive behavior and chemotherapy resistance in BC. We aimed to

analyze this factor as a potential prognostic marker to predict overall and

progression-free survival.

Methods: We examined the mRNA prole in tissue of BCBM patients

(n = 18). Using qPCR, we analyzed expression levels of Rad51, CDH1,

CDH2 and BC-specic markers (HER2) in these samples as well as healthy

breast and brain tissue. Clinical and survival data were analyzed regarding

the genetic tumor prole. For statistics, Mann-Whitney-U-tests, ROC-,

Kaplan-Meier-analysis and Spearman-correlations were used.

Results: Factors like patient age and tumor localization did not markedly

aect overall survival. A higher expression of Rad51 was found to result

in signicantly lower overall (p = 0,047) and BCBM-free patient survival

(p = 0,025). We observed an increase in BCBM-free survival in patients

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts104

with high expressions of CDH1 (p = 0,029) and HER2 (p = 0,004). e

expression levels of CDH1 showed a signicant inverse correlation to

those of CDH2 (p = 0,032).

Discussion: e association of decreased survival and increased Rad51

expression points to a protective eect of Rad51 on the tumor environment,

resulting in disease progression. However, higher HER2 and lower CDH2

expression seem to be positive prognostic factors in predicting BCBM-free

survival. e epithelial marker CDH1 may indicate a less aggressive pheno-

type, possibly marking a resting tumor cell state aer epithelial mesenchy-

mal and mesenchymal epithelial transition during metastatic spread.

Conclusion: e signicant negative impact of high Rad51 expression

on overall and BCBM-free survival indicates that Rad51 may serve as an

interesting therapeutic target not only in primary BC but also in BCBM.

Disclosure Statement: e authors declare no conict of interest. is study is

funded by the Interdisciplinary Centre for Clinical Research (IZKF) Jena.

Disclosure Statement: e authors declare no conict of interest.

875

Impactand treatment pattern of second-line therapy in

patients with recurrent or metastatic head and necksquamous

cell carcinoma (r/m SCCHN) – a German multicenter

retrospective study (HEAT)

Michael Pogorzelski1; Konrad Klinghammer2; Thomas Hilser1;

Marcel Bourgeois3; Tessa Hattenhauer4; Rebekka Mispelbaum4;

Jonas Wiegmann3; Eyck von der Heyde5; Kerstin Lüdtke-Heckenkamp6;

Jens Atzpodien6; Justyna Rawluk7; Philipp Ivanyi8; Stefan Kasper-Virchow1;

Balint Tamaskovics9; Mareike Tometten3; Viktor Grünwald1,10

1Innere Klinik (Tumorforschung), Westdeutsches Tumorzentrum,

Universitätsklinikum Essen, Essen, Deutschland

2Klinik für Hämatologie und Onkologie, Charité Campus Benjamin Franklin,

Berlin, Deutschland

3Klinik für Hämatologie, Onkologie, Hämostaseologie und

Stammzelltransplantation (Med. Klinik IV), Uniklinik RWTH Aachen, Aachen,

Deutschland

4Hämatologie und Onkologie, Medizinische Klinik III, Universitätsklinikum Bonn,

Bonn, Deutschland

5Onkologie am Raschplatz, Hannover, Deutschland

6Internistische Onkologie und Hämatologie, Niels-Stensen-Kliniken, Franziskus-

Hospital Harderberg, Georgsmarienhütte, Deutschland

7Klinik für Innere Medizin I, Hämatologie, Onkologie und

Stammzelltransplanation, Universitätsklinikum Freiburg, Freiburg, Deutschland

8Klinik für Hämatologie, Hämostaseologie, Onkologie und

Stammzelltransplantation, Medizinische Hochschule Hannover, Hannover,

Deutschland

9Klinik für Strahlentherapie und Radioonkologie, Universitätsklinikum

Düsseldorf, Düsseldorf, Deutschland

10Klinik für Urologie, Westdeutsches Tumorzentrum, Universitätsklinikum Essen,

Essen, Deutschland

Background: Immune checkpoint inhibitors (CPI) are a rst-line (1L)

standard in patients (pts) with PD-L1 positive recurrent/metastatic squa-

mous cell carcinoma of the head and neck (r/m SCCHN). Cetuximab-

based chemotherapy (CTx) remains the standard of care for PD-L1

negative pts. Second-line (2L) options remain variable. We retrospectively

evaluated treatment patterns and ecacy of second-line (2L) therapy in

r/m SCCHN pts treated at German head and neck cancer centers.

Methods: Pts with r/m SCCHN who started palliative 1L therapy between

12/2019 and 12/2021 were eligible. Data were retrospectively collected in

nine centers and retrieved from medical records. Database was closed on

May 1st, 2023. Overall response rate (ORR) was evaluated according to

RECIST 1.1. Kaplan–Meier method, log rank test and Cox proportion-

al-hazard model were applied.

Result: In total, 179 pts were included. Baseline characteristics were:

median age 64.0 years, 25.7% female, 32.8% ECOG PS ≥ 2, main primary

location was oropharynx in 34.1%, (p16: positive 19.7%) followed by

oral cavity (26.8%). Median overall survival (OS) from start of 1L ther-

apy was 17.0 months (m) (95% CI 15.0 – 22.1). In 1L, 67.6% received

CPI monotherapy, 18.7% CPI/CTx and 13.0% cetuximab/CTx. At data

cut-o, 139 pts (78.5%) were progressive to 1L therapy. Of those, 47.4%

(N=66) received a 2L therapy with ORR of 37.9%, progression-free sur-

vival (PFS) of 3.8m and OS of 9.7m from start of 2L. Pts who received a

cetuximab-based regimen (68.5%) aer failure of 1L CPI-based therapy

had superior PFS (5.6 vs 2.2m; P = 0.01) and OS (11.4 vs 4.9m; P < 0.001)

vs those pts who received a non-cetuximab 2L regimen.

Discussion: Second-line therapy is initiated in approximately 50% r/m

SCCHN pts in a real-world setting. Cetuximab-based therapy showed

greater clinical activity aer 1L CPI failure. e retrospective nature of

our analysis and the selection of pts are major limitations.

Conclusion: Cetuximab-based therapies show promise aer CPI failure.

Prospective studies evaluating the role of cetuximab following CPI failure

are warranted.

Disclosure Statement: e authors declare the following: Consultancy, Honoraria

and Travel Support: Boehringer Ingelheim, Bristol Myers-Squibb, Lilly, Merck

Healthcare KGaA, Merck Sharp & Dohme, Roche, Sano Aventis, Servier.

880

The correlation between oral mucositis and oncological

outcomes in patients undergoing radiation therapy for head

and neck cancer: a prospective study

Elsa Beatriz Monroy Ordonez; Andreas Thomsen; Michael Henke;

Raluca G. Stoian; Henning Schäfer; Anca-L. Grosu; Tanja Sprave

Klinik für Strahlenheilkunde Universitätsklinikum Freiburg, Freiburg im

Breisgau, Deutschland

Background: e correlation between oral mucositis and oncological out-

comes in patients undergoing radiation therapy for head and neck cancer:

a prospective study

Methods: 84 patients treated with primary or adjuvant radio(chemo)ther-

apy for locally advanced squamous cell carcinoma of the head and neck

at the Department of Radiation Oncology, University Hospital Freiburg,

Germany, were included. e main focus was a predened recording

of mucositis. For this purpose, a clinical examination of the patients was

performed twice a week by a specially trained examiner. is involved sys-

tematic examination of the eight regions of the oral mucosa: hard and so

palate, tongue, oor of the mouth, upper and lower lip, le and right buccal.

Tumor control rate was recorded during regular oncological follow-up.

Result: e median follow-up was 19 months. 62 (73.8%) participants

received primary denitive therapy and 22 (26.2%) patients received

adjuvant radio(chemo)therapy. e most common tumor locations were

oropharynx n=37 (44%), oral cavity n=22 (26.2%), and hypopharynx

n=20 (23.8%). Median dose was 69.3 Gy (range 52-70 Gy). 47 participants

developed grade 3 oral mucositis aer a median dose of 32 Gy. e col-

lective was stratied by mucositis grade 3 vs. w/o mucositis grade 3. ere

was no signicant dierence in overall survival and progression-free

survival between both groups (log-rank p=0.15 and log-rank p=0.29).

e cumulative incidence of locoregional failures was also not dierent

between the two arms (n=8 in each arm, log-rank p=0.75). e cumula-

tive incidence of distant metastases was not signicantly dierent between

arms (n=9 in the mucositis grade 3 group vs. n=6 w/o mucositis grad 3

group, log-rank p=0.72).

Conclusion: e high-grade oral mucositis does not appear to compro-

mise oncologic response. is nding will be validated in larger multi-

center collectives.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 105

933

Coherence between macrophage inltration/polarisation and

the immune checkpoints of the PD1/PD-L axis in the induction

of immunosuppression in oral mucosal lesions

Manuel Weber; Rainer Lutz; Marco Kesting; Jutta Ries

Mund-, Kiefer- und Gesichtschirurgische Klinik Erlangen, Erlangen, Deutschland

Background: Immune checkpoint inhibitors (ICI), particularly inhib-

itors of the PD1/PD-L1/PD-L2 axis have become extremely prominent

in tumor therapy. It is shiwn the immune checkponts as well as tumor

inltrating macrophages and their polarization towards the immunosup-

pressive M2-like type are relevent for mlignant transformation and pro-

gression of oral squamous cell carcinomas (OSCC). Aim of this study was

to clarify whether increased expression of the immune checkpoints of the

PD1 axis are associated with increased inltration of macrophages and the

shi towards M2 polarization.

Material and Methods: A total of 178 tissue samples were included.

102 oral leukoplakia (OLP) (non-transforming OLP=53, transform-

ing OLP=49), 48 OSCC and 48 healthy oral mucosa samples (NOM).

Expression levels of CD68 (generic macrophage marker), CD11c (M1)

and CD163 (M2) as well as PD1, PD-L1 and PD-L2 were quantied

by immunohistochemistry (IHC). Correlation was tested using the

Spearman-Rho test.

Results: In the epithelium, macrophage inltration (CD68) and

increased expression of PD1, PD-L1 and PD-L2 correlated signicantly.

Additionally, in the epithelium the polarisation of macrophages towards

M2 correlated with the overexpression of PD-L1. Epithelial expression

of CD163 and CD11c was correlated with overexpression of PD-L1 and

PD-L2. Subepithelially, the expression of PD1 and CD68, CD163 and

CD11c correlated moderately.

Conclusion: In the present study, a positive correlation was found in oral

mucosal lesions between the expression of PD1/PD-L1 axis and macro-

phage inltration and polarization towards M2. ese results suggest that

the increased expression of the checkpoints could promote the recruit-

ment of TAMs or vice versa. is could trigger immunosuppression and

possibly tumour initiation and progression.

Disclosure Statement: e authors declare no conict of interest.

938

Two Heads Are Better Than One: Interobserver Variability of

Tumor Contouring in the Prospective NAVIGATORR Trial

Lukas Bauer1; Sebastian Regnery1; Reinald Kühle2; Jennifer Fuchs2;

Julius Moratin2; Florian Stritzke1; Philipp Schröter1; Katharina Weusthof1;

Maximilian Deng1; Sebastian Adeberg3; Jürgen Homann2; Jürgen Peter

Debus1; Christian Freudlsperger2; Thomas Held1

1Abteilung für Radioonkologie und Strahlentherapie, Univiversitätsklinik

Heidelberg, Heidelberg, Deutschland

2Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie,

Universitätsklinikum Heidelberg, Heidelberg, Deutschland

3Klinik für Strahlentherapie, Universitätsklinikum Marburg, Marburg,

Deutschland

Background: Careful review of preoperative imaging is essential to

achieve complete resection of locally-advanced head-and-neck cancers

(HNC). In the prospective clinical NAVIGATORR trial we establish a

new interdisciplinary workow. Here we assess interobserver variability

in tumor contouring in preoperative imaging and its possible impact on

intraoperative navigation.

Methods: NAVIGATORR is a prospective clinical trial that enrolls 60

patients with locally-advanced HNC of the skull base. Patients undergo

tumor resection with an intraoperative optical navigation system

(Brainlab, Munich, Germany). Tumor contouring in preoperative imaging

(MRI) is done seperately by an oral and maxillofacial surgery (OMS)

specialist and a radiation oncologist. Subsequently, dierences in tumor

contouring between specialities are discussed. To evaluate dierences in

tumor contouring, we compared tumor volumes and calculated the Dice

similarity coecient (DSC) and the 95th percentile of the Hausdor dis-

tance (HD95). DICE and HD95 were assessed on a spectrum from “Very

Poor” to “Good” based on prior research.

Result: So far, preoperative tumor contouring was done in six patients

that underwent navigation-based tumor resection. In comparison, tumor

volumes contoured by the OMS specialist were higher. DSC values showed

“Good” and “Good-intermediate” overlap between tumor contours. HD95

values indicated “Good” and “Good-intermediate” agreement.

Discussion: Our early ndings support the feasibility and possible bene-

t of our interdisciplinary workow. However, NAVIGATORR remains a

project under development. We eagerly anticipate the availability of more

comprehensive and rened data.

Conclusion: Discussion of preoperative tumor volumes might enhance

oncological safe tumor resection.

Disclosure Statement: e authors declare the following: RK and CF previously

acted as advisors of Brainlab, Germany.

939

Increased PD1/PD-L1/2 expression is linked to MAGE-A

expression during oral cancer development

Manuel Weber; Rainer Lutz; Marco Kesting; Jutta Ries

Mund-, Kiefer- und Gesichtschirurgische Klinik Erlangen, Erlangen, Deutschland

Background: MAGE-A tumor antigen expression is restricted to malig-

nant and promptly malignant transforming oral mucosa. MAGE-A anti-

gens can act as neoantigens and cause an immune reactions. However,

immunologic clearance of MAGE-A expressing cells is not successful

when oral squamous cell carcinomas (OSCC) develop from precursor

lesions, oral leukoplakias (OLP). Local immunosuppression via the PD1/

PD-L1/2 axis might contribute to immune evasion of MAGE-A express-

ing cells during malignant transformation. e aim of this study was to

determine whether reactivation of MAGE-A expression in oral epithe-

lium during malignant transformation is associated with expression PD1/

PD-L1/PD-L2 axis.

Material and Methods: A total of 221 tissue samples were included: OLP

(n=134), OSCC (n=50) and healthy oral mucosa (NOM, n=37). In all

samples, the expression of MAGE-A antigens was determined by immu-

nohistochemistry (IHC) using 57b antibody and they were divided into 2

groups, positive and negative for MAGE-A. Expression of PD-1, PDL-1

and PD-L2 were determined by RT-qPCR and IHC.

Results: MAGE-A expression was signicantly associated with tissue

inammation level (p=0.001). RT-qPCR showed signicant overexpres-

sion of the ligands, PD-L1 and 2 in MAGE-A positive and in inamed

tissue (p=0.001). Expression of the immune checkpoints demonstrated

signicantly increased expression of PD-L1 (p=0.01) and PD-L2 (p=0.004)

in the epithelium of the MAGE-A positive group. e degree of inam-

mation was signicantly associated with the increased expression of the

ligands in the epithelium (pPD-L1=0.0001, pPD-L2=0.001) and the receptor

PD1 in the subepithelium (pPD1=0.04).

Conclusions: Increased expression of the immune checkpoint pathway

PD1/PD-L1/2 is statistically signicantly coupled to MAGE-A expres-

sion in oral epithelium and during oral carcinogenesis. is may indicate

that MAGE-A induces immunosuppression via the PD1 axis, preventing

immunologic clearance of MAGE-A expressing cells promoting malig-

nant transformation.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts106

942

BTLA: An immune modulator of local immunosuppression and

a potential target for (combination) immunotherapies in oral

cancer

Leah Trumet1; Manuel Weber2; Rainer Lutz2; Marco Kesting2; Jutta Ries2

1Zahnklinik 1, Erlangen, Deutschland

2Mund-, Kiefer- und Gesichtschirurgische Klinik Erlangen, Erlangen,

Deutschland

Background: In oral squamous cell carcinoma (OSCC), a complex immu-

notolerant microenvironment can be observed. Only a small proportion

of patients respond to immune checkpoint inhibitors against PD1/PD-L1.

erefore, new therapeutics, especially immunological combination ther-

apies, must be developed.

e inhibitory immune checkpoint BTLA is upregulated in many tumour

entities and correlates negatively with prognosis. erefore, it is consid-

ered a potential target for antibody-based immunotherapy. Moreover,

BTLA is already targeted in experimental combination ICI studies.

e aim of the study was to examine whether the immune checkpoint

BTLA is overexpressed in tissue samples from OSCC-patients compared

to healthy volunteers (NOM) and if its expression is correlated with the

PD1 axis.

Material and Methods: 102 tumor tissue samples of initial diagnosed

OSCC patients and 105 oral mucosa tissues (NOM) were included. e

expression of BTLA-1/2, as well as of PD1, PD-L1 and 2 were determined

by RT-qPCR. e expression of BTLA protein was also quantied by

immunohistochemistry. e expression levels were compared between

both groups, relative expression dierences were calculated and the sta-

tistical relevance of dierential gene expression was determined. e

expression of BTLA was correlated to expression levels of the PD axis

modulators using Spearman-Rho test.

Results: BTLA expression was signicantly increased in tissue of OSCC

compared to NOM (PBTLA_1= 0.003; PBTLA_2= 0.0001, PIHC=0.003). e

expression of PD1 and its ligands was signicantly increased in OSCC.

ere was a strong correlation between BTLA and the expression of

checkpoints PD-1, PD-L1 and PD-L2.

Conclusions: BTLA is upregulated in OSCC compared to healthy mucosa.

BTLA expression correlates signicantly with PD1 and PD-L1/2 and

appears to be a potentially relevant local immune checkpoint in OSCC.

Antibodies against BTLA could be used as potential candidates, especially

in combination with ICI against the PD1 axis, for immunotherapies in

OSCC.

Disclosure Statement: e authors declare no conict of interest.

950

Inuence of MAGE-A expression in oral mucosal lesions on

macrophage invasion and polarization

Jutta Ries; Rainer Lutz; Marco Kesting; Manuel Weber

Mund-, Kiefer- und Gesichtschirurgische Klinik Erlangen, Erlangen, Deutschland

Background: Pre-/malignant cells express tumor antigens trough which

they are recognised by the immune system as foreign and destroyed by

triggered immune reactions. However, long-lasting immune reactions

are dampened by immune modulators, but also by immune cells such

as macrophages. In the oral cavity, the expression of MAGE-A antigens

is restricted to malignant and promptly transforming tissues, trigger-

ing a strong, long-lasting immune response that ultimately leads to an

immunosuppressive environment. In addition, a shi in macrophage

polarisation towards M2 has been observed in tumours and transform-

ing leucoplakias, which suggests local immunosuppression. e aim of

this study was to test whether reactivation of MAGE-A expression has an

inuence on the immunosuppression induced by macrophage inltration

and M2 polarization in the tissue.

Material and Methods: 134 leucoplakias, 50 tumors and 49 healthy oral

mucosa samples were analyzed. e expression of MAGE-A antigens 1-6,

10 and 12 was investigated by immunohistochemistry (IHC) with the

antibody 57b. Subsequently, the samples were divided into MAGE-A pos-

itive and negative. e expression levels of CD68 (macrophages), CD11c

(M1) and CD163 (M2) were quantied by IHC and compared between

both groups. e statistical relevance of the expression dierences was

determined. Epithelium and subepithelium were analyzed separately.

Results: ere was a signicant overexpression of CD68 in epithelium

and subepithelium of MAGE-A positive compared to negative samples

(p=0.001, FCE=2.5; FCS=1.2) indicating increased macrophage-inltra-

tion. e signicant overexpression of CD163 in the MAGE-A express-

ing group indicates M2 polarization and thus local immunosuppression

(pCD163_E=0.001, FCCD163_E=3.5; pCD163_S=0.007).

Conclusions: MAGE-A expression is accompanied by increased macro-

phage inltration and M2 polarization. is may cause a local immuno-

suppressive environment preventing an eective immune reaction against

MAGE-A expressing cells during malignant transformation of oral epi-

thelial cells.

Disclosure Statement: e authors declare no conict of interest.

951

The role of the transcription factor Oct-4A in the initiation and

progression of head-and-neck tumors

Jutta Ries1; Christoph Baran1; Emeka Nkenke2; Abbas Agaimy3;

Claudia Wickenhauser4; Manuel Weber1

1Mund-, Kiefer- und Gesichtschirurgische Klinik Erlangen, Erlangen,

Deutschland

2Allgemeines Krankenhaus der Stadt Wien, Wien, Österreich

3Pathologie des Uni-Klinikums Erlangen, Erlangen, Deutschland

4Universitätsklinikum Halle-Saale Institut für Pathologie, Halle (Saale),

Deutschland

Background: Oct-4 (POU class 5 homeobox 1) is considered one of the

main regulators responsible for maintaining pluripotency and self-renewal

of embryonic stem cells. Several studies have shown that Oct-4 is overex-

pressed in adult somatic stem cells, cancer precursor cells of precancerous

lesions (OLP) and in cancer stem cells of solid tumours. us, it may play

a role in the initiation and progression of carcinomas, including head and

neck squamous cell carcinoma (cancer stem cell hypothesis). However,

these results are controversial. In many studies, expression analysis did

not distinguish between individual isoforms of Oct4 generated by alterna-

tive splicing and referred to as Oct4A, Oct4B and Oct4B1. However, only

the nuclear-specic Oct4A isoform, as a transcription factor, regulates the

pluripotent nature of stem cells. erefore, to elucidate its expression and

biological signicance, it is important to distinguish between the dier-

ent isoforms. e aim of this study was to exclusively analyze the expres-

sion of the transcription factor Oct-4A in healthy oral tissue (NOM), oral

squamous cell carcinomas (OSCC), OLP, in cell cultures of enriched oral

cancer stem cells, to determine the importance of this isoform in OSCC.

Material and Methods: Oct-4A expression was analyzed in forma-

lin-xed, paran-embedded samples from 191 OLP, 88 OSCC and 19

NOM samples by immunohistochemistry (IHC) and RT-PCR using an

Oct4A-specic antibody and isoform-specic primers. Fluorescence-

based cell sorting enriched stem cells of OSCC cell cultures were exam-

ined by FACS and RT-PCR.

Results: Oct-4A was rarely expressed. 2.7% of all samples stained specif-

ically in IHC and no expression of Oct-4a could be shown in any of the

samples eg. OSCC cell cultures examined by RT-PCR.

Conclusion: e results may indicate that the transcription factor Oct-4A

plays a minor role in the initiation and progression of OSCC. However, it

could also be postulated that stem cells occur very rarely in somatic, pre-

cancerous, and malignant tissues and therefore cannot be detected, even

with highly sensitive methods.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 107

Health Economy/Public Health

Sexual and Gender Minorities and Cancer in Germany: Making

the Health Needs of Lesbian, Gay, Bisexual and Transgender

People visible

Gabriele Dennert1; Ulrike Boehmer2

1Fachhochschule Dortmund, Dortmund, Deutschland

2Boston University School of Public Health, Department of Community Health

Sciences, Boston, USA

Background: e health – and in particular: cancer-related health – of

sexual and gender minority (SGM) or LGBT (lesbian, gay, bisexual,

transgender) populations remains a largely neglected topic in Germany.

is presentation will focus on SGM populations’ cancer-related health

in Germany by providing an overview of the available evidence, gaps in

existing data, and recommendations to improve cancer-related health

among SGM/LGBT populations. (1)

Methods: An extensive literature review was conducted on the available

data about SGM populations and cancer in Germany. e cancer control

continuum (2) served as a framework for the available evidence on cancer

risk factors, prevention, early detection, diagnosis, treatment, survivor-

ship, and end-of-life care among SGM populations.

Result: SGM populations experience unique health inequities in

cancer-related health in Germany. ere is a striking discrepancy between

the highly developed resource-intensive healthcare system and the com-

plete lack of SGM perspectives and awareness about SGM populations in

oncology.

Discussion: ere is a need to broaden the understanding of SGM and

cancer. Discrimination in health care and especially intersectional dis-

crimination has been described as a barrier to access to high-quality care

in Germany and likely negatively impacts SGM individuals’ quality of

cancer care.

Conclusion: Interventions and policies are needed to improve SGM peo-

ple’s access and quality of cancer care.

Indication of source:

1 Dennert, G. (2022): Sexual and Gender Minorities and Cancer in Germany:

e Striking Absence of Understanding eir Cancer-related Needs. In:

Boehmer, U. / Dennert, G. (Eds.): LGBT Populations and Cancer in the Global

Context. Springer, 2022: 189–213.

2 National Cancer Institute (2020): Cancer Control Continuum. https://

cancercontrol.cancer.gov/about-dccps/about-cc/cancer-control-continuum

(accessed: 23.08.2023).

Disclosure Statement: e authors declare no conict of interest.

134

Carbon emission estimates from breast cancer patient travel

to German Radiation Centers

Ahmed Bedir1; Steen Weimann2; Matthias Mäurer2; Dominik Hering3;

Maximilian Grohmann4; Michael Oertel3; Tobias Gauer4; Daniel

Medenwald1; Christoph Straube5

1Klinik und Poliklinik für Strahlentherapie, Universitätsklinikum Halle (Saale),

Halle (Saale), Deutschland

2Klinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Jena,

Jena, Deutschland

3Klinik für Strahlentherapie - Radioonkologie, Universitätsklinikum Münster,

Münster, Deutschland

4Klinik für Strahlentherapie und Radioonkologie, Universitätsklinikum

Hamburg-Eppendorf, Hamburg, Deutschland

5Klinik für Radioonkologie und Strahlentherapie, Klinikum Landshut, Landshut,

Deutschland

Background: Travel-related emissions are becoming a signicant concern

in the context of climate change. Traditional cancer treatment procedures,

such as external beam radiotherapy (EBRT), require patients to travel

extensively, signicantly contributing to carbon emissions. is study

aims to quantify carbon dioxide (CO2) emissions from patient travel

for breast cancer treatment at University Hospital Magdeburg (UKMD),

Medical Center Landshut (KL) and University Medical Center Hamburg-

Eppendorf (UKE) in Germany.

Methods: We analyzed the geographic data of breast cancer patients visit-

ing the radiotherapy clinic in UKMD, KL and UKE, calculating distances

using Google Maps. CO2 emissions were estimated assuming the use of a

standard 40 mpg petrol car emitting 0.168 kg of CO2 per km.

Result: Addresses from 2709 breast cancer patients treated between 2018-

2022 were analyzed (UKMD 1177; KL 617; UKE 915 patients). Our sam-

ple traveled on average 36.3 km for each radiation fraction during that time

period (average distance UKMD 50.2 km; KL 42.6 km; UKE: 14.2 km). is

yielded an estimated total of 6.1 kg of CO2 emissions per travel visit, resulting

in 152.5 kg emissions assuming 25 visits (planning, treatment, follow-up).

Discussion: e study points to the environmental impact of frequent

travel for EBRT. Limitations include the assumption of a single transpor-

tation method, unaccounted route alterations, and the potential inaccu-

racy of patient addresses. e study also standardizes the number of visits

to 25, but actual visit counts and transportation methods could aect real-

world emissions.

Conclusion: Several countries have transitioned to fewer fractions to cut

down health care costs and improve patient comfort without compromis-

ing treatment outcomes. Reducing the number of fractions to ve, for

instance, could substantially reduce the total travel distances and conse-

quently, CO2 emissions.

Disclosure Statement: e authors declare no conict of interest.

271

Real-time patient locating in a large oncology outpatient

center - proof of concept

Jan-Peter Glossmann1; René Tielsch-Nebel1; Beate Bergatt-Kuhl1;

Thomas Zander1; Jürgen Wolf1; Michael Butler1; Cornelia von Levetzow1;

Andreas Melzner1; Peter Weuthen2; Klaus Lipka2; Peter Heinen2;

Michael Hallek1

1CIO Cologne, University Hospital Cologne, Center for Integrated Oncology

Aachen Bonn Cologne Duesseldorf (CIO ABCD), Köln, Deutschland

2medfacilities GmbH, Köln, Deutschland

Background: Outpatient cancer care is a complex process requiring

patients, sta and treatment to be at the right time at the right place. Real-

time locating systems (RTLS) are in-house tracking systems that can track

patient location live. Generated data can be analyzed to improve the pro-

cess, quality and safety of care.

Methods: A RTLS system for cancer patients has been implemented at

the Center for Integrated Oncology ambulatory in Cologne, Germany.

Areliable RTLS was prerequisite which required a high density of digital

receivers (anchors) for triangulation. e patient tracking devices use

Ultra-Wideband (UWB) technology allowing accurate real-time locating.

Patients consent for using tracking data was prerequisite.

Result: e main goal was to improve patient experience and reducing wait-

ing times. e RTLS system allowed observing patient movements visualized

on a digital oor map and process dashboard of the cancer outpatient center.

During the pilot 350 patients (cycles) were tracked and generated ca. 100.000

data points. Tracking positions were updated all 10 sec. Accuracy was 20 cm

if required. Data analytics included real-time process dashboards as well as

utilization times of therapy chairs. Process mining was done and was visual-

ized in heat maps as well as spaghetti plots.

Discussion: RTLS technology should be part of modern oncology

care. It helps to identify clinical ineciencies and optimize workows.

Implementing ndings can signicantly improve scheduling, cycle times,

utilization of therapy chairs and waiting times. Potential downstream

eects of these interventions include improved patient experience and

safety, economic eciency, opportunities for expanding clinical capac-

ity and avoiding sta burnout. Implementing such systems have chal-

lenges regarding technology, data protection, the need of patient and sta

compliance.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts108

Conclusion: Real-time patient tracking can successfully be implemented

in outpatient cancer centers and it oers great chances for improving care

and patient experience.

Disclosure Statement: e authors declare no conict of interest.

282

Inadequate subsequent therapies in oncology trials –

consequences for interpreting overall survival

Philip Böhler; Sascha Abbas; Philip Kranz

Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen (IQWiG), Köln,

Deutschland

Background: Overall survival results are only informative for patient care

if subsequent therapies aer disease progression or recurrence comply

with the current standard of care.

Methods: German benet assessments were used to illustrate the subse-

quent therapies administered in oncology trials compared to the current

standard of care in the adjuvant treatment of renal cell carcinoma (study

KEYNOTE-564; Pembrolizumab vs. Placebo) and non-small cell lung

cancer (study IMpower010, Atezolizumab vs. Best Supportive Care). e

interpretability of overall survival results was assessed.

Result: In the comparator arm, 30% (study KEYNOTE-564) and 42% (study

IMpower010) of the patients had disease recurrence. Subsequent treatment

complying with the standard of care (i.e. immune checkpoint inhibitors)

was only administered to 31% (study KEYNOTE-564) and 47% (study

IMpower010) of the patients with disease recurrence in the comparator arm.

Overall survival results were deemed not interpretable since standard of care

subsequent therapies were not given to a majority of patients.

Discussion: Overall survival is not only inuenced by the initial study

treatment but also by subsequent therapies aer disease recurrence or

progression. Subsequent treatment of patients aer recurrence in the

comparator arms in the studies KEYNOTE-564 and IMpower010 was

insucient because it did not reect the current standard of care. e

observed positive overall survival eects for the investigated interventions

are therefore unreliable.

Conclusion: For meaningful overall survival results, subsequent therapies

aer disease recurrence or progression need to reect the current stan-

dard of care. is is of particular importance in situations where superi-

ority of a drug was already proven in a later line of therapy. Trial sponsors

should ensure that subsequent therapies are in line with the standard of

care in future oncology trials.

Disclosure Statement: e authors declare no conict of interest.

350

Implementing the DigiNet intervention from a healthcare

management perspective

Leonie Eilers1; Vanessa Mildenberger2; Anika Kästner3; Anna Spier2;

Dusan Simic2; Stephanie Stock2; Wolfgang Homann3; Anna Kron4,5;

Florian Kron1,4,6; Jürgen Wolf4,5

1KCM KompetenzCentrum für Medizinoekonomie, FOM Hochschule für

Oekonomie & Management gemeinnützige Gesellschaft mbH, Essen,

Deutschland

2Institute for Health Economics and Clinical Epidemiology, Faculty of Medicine

and University Hospital Cologne, University of Cologne, Cologne, Deutschland

3Institute for Community Medicine, Section Epidemiology of Health Care and

Community Health, University Medicine Greifswald, Greifswald, Deutschland

4Department I of Internal Medicine, Center for Integrated Oncology (CIO)

Aachen Bonn Cologne, Faculty of Medicine and University Hospital Cologne,

Cologne, Deutschland

5National Network Genomic Medicine (nNGM) Lung Cancer, Faculty of Medicine

and University Hospital Cologne, Cologne, Deutschland

6VITIS Healthcare Group, Cologne, Deutschland, Cologne, Deutschland

Background: Molecular diagnosis and personalized treatment are

becoming inevitably critical in lung cancer care. Due to the complex-

ity, a well-structured documentation and close connection of healthcare

providers throughout the patient journeys is crucial but also costly. e

DigiNet intervention1 aims to improve care for patients with advanced

non-small cell lung cancer through the digital connection of healthcare

providers, an expert committee and the collection of patient-reported out-

comes. is study aims to identify the facilitating and inhibiting factors of

implementing the DigiNet intervention from a healthcare management

perspective.

Methods: A qualitative approach is applied in which healthcare providers,

including oncologists and study assistants, are interviewed at the begin-

ning of the intervention. A semi-structured interview guide was devel-

oped based on a systematic literature review. e data was analyzed using

qualitative content analysis, according to Mayring.

Result: Lacking resources regarding time and personnel, particularly

for the enrollment and documentation of patients and other admin-

istrative processes, were identied as inhibiting factors during the

implementation process of the DigiNet intervention. Furthermore, the

additional costs oen needed to be cross-nanced by other resources.

Facilitating factors included among others the motivation to participate

in the project.

Discussion: e project’s primary eorts should be focused on the

improvement of patient care and its eciency. e necessary digitization

is a costly eort. us, more resources are required to implement this

intervention.

Conclusion: e study identied the determinants of change in the early

stages of introducing the DigiNet intervention into the health care system.

1 ClinicalTrials.gov. Identier NCT05818449 Improvement of Personalized Lung

Cancer Care rough Digital Connection and Patient Participation (DigiNet).

From: https://clinicaltrials.gov/study/NCT05818449.

Disclosure Statement: e authors declare no conict of interest.

408

Attitudes and concerns of persons with familial cancer risk

towards digital health technologies

Katharina Klein1; Paula Thomas1; Stephanie Stegen2; Stephen

Schüürhuis3; Sven Asmussen4; Nora Amirpour-Mehrhof5; Markus Feufel6;

Dorothee Speiser5; Christoph Kowalski7; Friederike Kendel1

1Charitè-Universitätsmedizin Berlin, Geschlechterforschung in der Medizin

(GiM), Berlin, Deutschland

2BRCA-Netzwerk e.V., Bonn, Deutschland

3Charité-Universitätsmedizin Berlin, Institut für Biometrie und Klinische

Epidemiologie, Berlin, Deutschland

4Humboldt-Universität zu Berlin, Lehrstuhl für Bürgerliches Recht,

Wirtschaftsrecht und Ökonomik, Berlin, Deutschland

5Charité-Universitätsmedizin Berlin, Zentrum Familiärer Brust- und

Eierstockkrebs, Klinik für Gynäkologie mit Brustzentrum, Berlin, Deutschland

6Technische Universität Berlin, Institut für Psychologie und Arbeitswissenschaft,

Berlin, Deutschland

7Deutsche Krebsgesellschaft e.V., Berlin, Deutschland

Background: e digital storage of health data in the electronic health

record (EHR) triggers intense discussions. Secure data storage is of great

importance, especially for persons with familial cancer risk (PFCR). It is

uncertain what attitudes PFCRs have towards the use of digital technologies.

As part of the development of a digital platform for PFCR (G-BA funded

project dVP_FAM, 01NVF20002), we investigated attitudes and concerns

regarding the introduction of an EHR. In addition, we assess whether PFCR

have diculties nding and evaluating health information online.

Methods: A cross-sectional online survey invitation was sent to individ-

uals at familial risk for cancer via the BRCA-Netzwerk e.V. e question-

naire included six items to assess attitudes toward the introduction of an

EHR. Identication of health information was assessed with the Digital

Health Literacy Instrument (1). Descriptive methods, statistical tests, and

correlation analyses were applied.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 109

Result: Two-hundred twenty-four Persons participated. Of the partic-

ipants, 71% (n=159) reported being able to nd health information on

the Internet. 66% (n=148) of the respondents felt able to distinguish reli-

able from questionable health information on the Internet. 64% (n=145)

expected that storing their health information in the EHR could improve

medical care. However, 42% (n=94) of participants also expressed con-

cerns about the security of having their health data stored in an EHR.

Discussion: e ndings highlights the importance of involving patients

in the development of digital health technologies to create solutions that

meet their needs and experiences.

Conclusion: e involvement of PFCR may promote the acceptance and

use of technologies, but also their eectiveness and long-term adaptability

in the changing healthcare environment.

1 Van Der Vaart R, Drossaert C. Development of the Digital Health Literacy

Instrument: Measuring a Broad Spectrum of Health 1.0 and Health 2.0 Skills.

JMed Internet Res. 2017:e27.

Disclosure Statement: e authors declare no conict of interest.

432

Decoding Patient Needs: Analyzing Media Portrayal of New

Cancer Drugs

Bettina Weniger; Bettina Linke; Marie-Jolin Köster

Deutsche Krebsgesellschaft, Berlin, Deutschland

Background: erapeutic options for cancer have greatly expanded in

recent years due to the development of numerous novel drugs. is study

deals with the presentation of these drugs in print media as well as with

information needs of cancer patients regarding new drugs.

Methods: A survey was conducted involving 80 cancer patients or their

relatives, along with a media analysis of six new cancer drugs. In addition,

a literature search on requirements for drug information for patients was

performed. Using the ndings, a set of criteria was formulated to oer

guidance in developing information for new drug introductions.

Result: e survey results show a substantial need for comprehensive

information about novel cancer drugs. Patients expressed the highest pri-

ority for details concerning both benets and risks. Respondents’ satis-

faction with the information on novel cancer drugs they received so far is

much lower than in other surveys with patients regarding general cancer

information. e media analysis shows there is little high-quality written

information on the selected drugs available for laypersons. In addition,

such information has little or no visibility on the internet. Furthermore,

its readability is poor. Articles are oen incomplete and sometimes unbal-

anced in terms of the benet-risk presentation.

Discussion: Due to the increasing prevalence and incidence of cancer, the

need for information on novel cancer drugs is expected to grow signi-

cantly in the near future. Existing information from print media is oen

incomplete and unbalanced. A small selection of information can be use-

ful for informative decision making for patients.

Conclusion: It is necessary to improve and to further develop drug informa-

tion for cancer patients. e awareness and visibility of high-quality infor-

mation should be increased and more independent, easy-to-understand, and

accessible information resources should be created. Moreover, it is important

to improve existing services in terms of content and readability.

Disclosure Statement: e authors declare no conict of interest.

525

Next-generation sequencing for sepsis diagnosis -A budget

impact analysis in the treatment of hemato-oncological

patients

Ann-Cathrine Siefen1; Jannis Trümmler1; Florian Jakobs1,2; Florian Kron1,3,4,5

1VITIS Healthcare Group, Köln, Deutschland

2Department of Hematology and Stem Cell Transplantation, University Hospital

Essen, Essen, Deutschland

3University of Cologne, Faculty of Medicine and University Hospital Cologne,

Department I of Internal Medicine, Köln, Deutschland

4FOM University of Applied Sciences, Essen, Deutschland

5University of Cologne, Faculty of Medicine and University Hospital Cologne,

Center for Inte-grated Oncology (CIO ABCD), Köln, Deutschland

Background: Sepsis accounts for over 20% of global mortality and is

associated with high in-hospital morbidity. Next-generation sequencing

(NGS) oers faster and more sensitive DNA analysis for sepsis identi-

cation compared to blood cultures, allowing targeted therapy. However,

evaluating the cost-eectiveness of innovative procedures is crucial due

to increasing healthcare expenses. is study aimed to analyze the budget

impact of NGS on inpatient costs from a payer perspective in Germany.

Methods: Real-world cost data from two hemato-oncology departments

(University Hospitals Cologne and Essen) were collected. Eligibility criteria

were oncologic main diagnosis, requested blood culture, and sepsis diag-

nosis. Based on Grumaz et al., cost savings were calculated by modeling a

length of stay (LOS) reduction of 8 days (general ward) and 4 days (intensive

care unit) for patients who were high outliers in LOS (1). We assumed an

NGS positivity rate of 71%. e analysis compared NGS procedure costs

(€1.499) with modeled cost savings from shortened LOS on a case basis.

Result: 208 cases were analyzed. Average cost savings amount to €2.272,39

(95% CI: 2.050,3-2.494,5). Further, a budget impact of €773,39 (551,3-

995,5) per case was identied for the entire study population.

Discussion: Our budget impact analysis showed that NGS resulted in

cost savings supporting decision-makers in implementing this innovative

approach in the German healthcare sector. With a comprehensive imple-

mentation, procedure costs are expected to decrease further.

Conclusion: NGS leads to cost savings, improved patient care, and con-

taining unnecessary treatments and their costs.

Indication of source:

1. Grumaz S, Grumaz C, Vainshtein Y, Stevens P, Glanz K, Decker SO,

et al. Enhanced Performance of Next-Generation Sequencing Diagnostics

Compared With Standard of Care Microbiological Diagnostics in Patients

Suering From Septic Shock. Crit Care Med. 2019;47(5):e394-e402.

Disclosure Statement: e authors declare the following: A-C Siefen, J Trümmler

and F Kron are employees of the VITIS Healthcare Group, which was sponsored

by Noscendo GmbH in connection with the development of the study. e

funder of the study had no role in study design, data collection, data analysis,

or data interpretation and writing of the abstract. F Jakobs received consulting

fees or honorarium for participation on an Advisory Board from Alexion, Cerus,

Noscendo, Novartis, Pzer, Seagen.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts110

558

Quantitative analysis of the impact of the nursing strike

2022 in NRW on oncological care at the Center for Integrated

Oncology (CIO)

Scarlett Berressem1; Anja Köchel2; Nicolas Sauerbrunn2; Michael

Neumann3; Katharina Lichius3; Christiane Döge3; Andreas Stutzki4;

Cornelia von Levetzow1

1CIO Cologne, University Hospital Cologne, Center for Integrated Oncology

Aachen Bonn Cologne Duesseldorf (CIO ABCD), Cologne, Deutschland

2CIO Aachen, University Hospital Aachen, Center for Integrated Oncology

Aachen Bonn Cologne Duesseldorf (CIO ABCD), Aachen, Deutschland

3CIO Bonn, University Hospital Bonn, Center for Integrated Oncology Aachen

Bonn Cologne Duesseldorf (CIO ABCD), Bonn, Deutschland

4CIO Duesseldorf, University Hospital Duesseldorf, Center for Integrated

Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Duesseldorf,

Deutschland

Background: In 2022 nursing sta of the university hospitals in NRW

went on strike for 79 days in May, June and July. During the strike,

numerous operations, diagnostic steps and therapies had to be cancelled

or postponed. e extent to which this also aected oncology patients

will be determined in an initial analysis based on controlling and cancer

registry data.

Methods: Dierent categories were dened to represent the quantitative

eects. A: number of tumorboard recommendations (TBs), B: number

of oncological surgical interventions (SI), C: number of inpatients with

chemotherapy (CTX), D: number of inpatients with radiotherapy (RTX).

Controlling and cancer registry data of CIO Cologne were used as data

basis. To increase the sample size, category B was expanded to include

data from the CIO sites Aachen, Bonn, Duesseldorf.

Result: ere was a 10-14% reduction of TBs during the strike, followed

by a 15% increase above annual mean (AM) in August. e overall annual

values signicantly exceeded the previous year’s values. In May the num-

ber of patients with SI in the CIO Aachen Bonn Cologne Düsseldorf was

36% below the AM, followed by an increase in SI of almost 20% in August

compared to the AM. In May and June, approximately 10% less patients

with planned CTX were admitted than the AM. Minimal reductions could

also be seen in patients with RTX in one month, June (4-11%).

Discussion: e number of SI patients in the four CIO sites during the

strike declined signicantly. e previous year’s numbers (2021: Covid

pandemic) could not be achieved over the course of the year. e num-

ber of TBs in CIO Cologne was reduced during the strike. Decreases in

the number of CTX and RTX inpatients were also observed, whereby

the impact on the RTX patients was lower. Nevertheless, the individual

areas (except for SI) achieved high overall annual values, demonstrating a

recovery during the year.

Conclusion: e strike had signicant quantitative eects, especially on

surgical interventions. Qualitative eects and long-term consequences

should be investigated in further studies focusing on patient follow up.

Disclosure Statement: e authors declare no conict of interest.

650

Trans-sectoral personalized care concept for patients with

rare cancer (TARGET): testing a new form of care

Vanessa Kratzer1; Hana Algül1,2; Birte Berger-Höger3; Michael von

Bergwelt-Baildon4; Volker Heinemann1,4; Ramona Gaube5;

Ursula Kronawitter6; Friederike Mumm1,4; Daniel Nasseh1;

Maximilian Reichert2; Sandra Riesch7; Oliver Schöski8; Anke Steckelberg9;

C. Benedikt Westphalen1,4; Martin Zünkeler10; Karin Berger4;

On Behalf of the Target-Study Group11

1Comprehensive Cancer Center Munich, Munich, Deutschland

2Department of Internal Medicine II, Technical University of Munich, School of

Medicine, University Hospital rechts der Isar, Munich, Deutschland

3Institute for Public Health and Nursing Research, University of Bremen,

Bremen, Deutschland

4Department of Medicine III, LMU University Hospital, LMU Munich, Munich,

Deutschland

5Association of Statutory Health Insurance Physicians in Bavaria, eHealth and

digital future Department of Health Care Innovations, Munich, Deutschland

6Association of Specialists in Haematology and Medical Oncology in Germany

e.V., Southern Bavaria, Traunstein, Deutschland

7AOK-Bayern-Die Gesundheitskasse, Division Supply Management Strategy and

Contracts Department, Munich, Deutschland

8Health Management, School of Business, Economics and Society, Friedrich-

Alexander University (FAU) Erlangen-Nürnberg, Nuremberg, Deutschland

9Institute of Health and Nursing Science, Medical Faculty of Martin Luther

University Halle-Wittenberg, Halle (Saale), Deutschland

10KAIROS GmbH, Bochum, Deutschland

11Munich, Deutschland

Background: In the case of rare cancers, interdisciplinary expertise and

optimized communication between patients and their treatment team are

essential to provide patient-centered care. e Trans-sectoral Personalised

Care Concept for Patients with Rare Cancers (TARGET), funded by the

innovation fund at the G-BA, aims to enhance trans-sectoral patient-cen-

tered care coordination in patients with rare cancers in South Bavaria.

Methods: Mixed methods design, enrolling patients with rare cancers

diagnosis, insured by AOK-Bayern. Interventional measures: structured

access to specialized rare cancer care (clinical contact person, CCC-

Munich), virtual tumor boards with participation of oce-based oncol-

ogists, an electronic case le to streamline trans-sectoral information

exchange, virtual psycho-oncology to bridge access to long-term local

care, Onco-Coach to provide coordinative support, and a patient app e.g.

chat with Onco-Coach, distress thermometer. Oce-based oncologist

have access to online and onsite shared decision making training, patients

have access to the decision support tool and decision coaching services.

e summative, formative and health economic evaluation will assess the

following endpoints: Coordination of care from the patient’s perspective

(CCI-D), progression-free survival, overall survival, treatment progres-

sion, time to diagnosis, patient-reported outcomes (EORTC QLQ-C30),

health literacy (FCCHL), and resource consumption. Control groups are

formed by observational study, patient survey, secondary data, and claims

data use.

Result: TARGET runs from 2022-2025: Preparation phase is completed,

control groups and intervention group (Enrollment: 03/2023-06/2024) are

running and data collection for evaluation is ongoing.

Discussion: Evaluation will show to what extent TARGET can optimize

Germany’s fragmented healthcare system.

Conclusion: It is expected that TARGET will improve care coordina-

tion, enhance quality of life, and lead to longer (overall/progression-free)

survival.

Disclosure Statement: e authors declare the following: e project on which

this publication is based was funded by the Innovation Committee of the Joint

Federal Committee under the funding code 01NVF20012.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 111

777

Economic inuences on medical decision-making in oncology:

a qualitative and quantitative approach

Julia König1; Birthe Aufenberg2; Sabine Sommerlatte3; Jan Schildmann3;

Wolfgang Greiner2; Eva Winkler1; Katja Mehlis1

1Klinik für Medizinische Onkologie, Nationales Centrum für Tumorerkrankungen

Heidelberg, Medizinische Fakultät Heidelberg, Universitätsklinik Heidelberg,

Heidelberg, Deutschland

2Gesundheitsökonomie und Gesundheitsmanagement, Fakultät für

Gesundheitswissenschaften, Universität Bielefeld, Bielefeld, Deutschland

3Institut für Geschichte und Ethik der Medizin, Martin-Luther-Universität

Halle-Wittenberg, Halle (Saale), Deutschland

Purpose: e possible inuence of economic factors on medical deci-

sion-making is widely discussed, but little is known about specic deci-

sion-making situations that are inuenced by economic factors in German

oncology and the extent to which they are impactful.

Methods: To identify situations inuenced by economic considerations,

15 qualitative semi-structured interviews were conducted with physi-

cians who had experience in controlling and budgeting in oncology,

audio-recorded, transcribed and evaluated by means of qualitative con-

tent analysis. Subsequently, medical decision-making situations in which

economic considerations had a substantial impact, were identied, cat-

egorized and, if possible, operationalized for identication in German

claims data. e prevalence of the operationalized situations was analyzed

exploratively. Depending on their type, further analyses were carried out.

Results: Several decisions regarding patient care that were strongly inu-

enced by economic considerations were identied. ese decisions con-

cerned (1) diagnostic procedures, (2) application form and (3) frequency

in systemic treatment and (4) application form and (5) frequency in

localized therapeutic interventions. Several factors were identied that

inuenced economic considerations: e.g. treatment price, infrastructure,

patients’ frailty, and clinical sector. Preliminary results of claims data anal-

ysis will be available at presentation.

Discussion: Economic inuences eect decision-making situations in

German oncology and present incentives that have the potential to reduce

quality of patient care and could lead to rationalization. However, eco-

nomic considerations also provide an important gate-keeping function to

ensure that resources are not spent unnecessarily.

Conclusions: Economic considerations are part of oncology and inu-

ence daily practice. erefore, awareness for economic inuences should

be raised in the oncological community and recommendations on how to

deal appropriately with economic inuences should be developed.

Disclosure Statement: e authors declare no conict of interest.

786

Access to healthcare, experiences with care coordination,

patients’ needs, and expectations: the rare cancer patients’

perspective

Laura Oestreich1; Myrto Boukovala1; Theres Fey2; Volker Heinemann3;

Jana Hinneburg4; Vanessa Kratzer2; Julia Lühnen5; Friederike Mumm3;

Theresia Pichler3; Anna Patricia Schön1; Anke Steckelberg4; Michael von

Bergwelt-Baildon1; C. Benedikt Westphalen3; Sandro Zacher4; Danmei

Zhang1; Karin Berger1; On Behalf of the Target-Study Group6

1Department of Medicine III, LMU University Hospital Munich, Munich,

Deutschland

2Comprehensive Cancer Center (CCC Munich LMU), LMU University Hospital

Munich, Munich, Deutschland

3Department of Medicine III and Comprehensive Cancer Center (CCC Munich

LMU), LMU University Hospital Munich, Munich, Deutschland

4Institute for Health and Nursing Science, Interdisciplinary Centre for Health

Sciences, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle

(Saale), Deutschland

5Institute of Clinical Nursing Science, Charité – Universitätsmedizin Berlin,

corporate member of Freie Universität Berlin and Humboldt Universität zu

Berlin, Berlin, Deutschland

6Munich, Deutschland

Background: Patients with rare cancers oen face challenges, such as

delays in diagnosis, limited access to specialized care, and coordination

hurdles among multiple healthcare providers. In Germany, evidence on

these aspects and patients’ needs is scarce. In the context of the G-BA

Innovation Fund project “Trans-sectoral personalized care concept for

patients with rare cancers (TARGET)”, we aim to explore the patients’

perspective.

Methods: is observational study is based on an online survey includ-

ing patients with a rare cancer diagnosis. e questionnaire is based

on explorative, semi-structured interviews (CCC LMU), and pilot-

tested. e survey includes the Care Coordination Instrument (CCI)1.

Distribution channels are CCC Munich departments, outpatient prac-

tices, and Bavarian cancer support groups.

Result: e study will continue until the end of 2023. In the interviews,

patients reported challenges regarding referrals to specialist centers, insuf-

cient guidance for supportive care, and lack information on potential

access to clinical studies, wishing for broader information for these top-

ics. e survey results on access to healthcare (e.g. access to specialists/

supportive care, time interval from rst symptoms to diagnosis), care

coordination from patients’ perspective (CCI), health literacy, patient sat-

isfaction and expectations will be stratied, e.g. by dierences between age

groups and geographical regions.

Discussion: e survey will lead to a better understanding on patients’

perspectives, routes to diagnosis/treatment, experiences and needs of

patients with rare cancer. Further, the results will serve as a control group

for the evaluation of the care concept TARGET.

Conclusion: e generated information will provide valuable insights

for discussions on optimizing healthcare structures to ensure future

patient-centered rare cancer care.

Indication of source:

1 Okado, I. et al. “Development and psychometric evaluation of a questionnaire

to measure cancer patients’ perception of care coordination”. BMC Health Serv

Res, 2020. 20(1): 52.

Disclosure Statement: e authors declare the following: e project on which

this publication is based was funded by the Innovation Committee of the Joint

Federal Committee under the funding code 01NVF20012.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts112

Hematooncology including Bone marrow

transplantation, Lymphoma, Plasmocytoma

Non-myeloablative (NMA) allogeneic hematopoietic stem cell

transplantation (alloHSCT) for elderly and comorbid patients

(pts) with acute lymphoblastic leukemia (ALL)

David Beverungen1; Heiko Trautmann2; Theresa Tumewu1; Madlen

Jentzsch1; Sebastian Schwind1; Georg-Nikolaus Franke1; Dietger

Niederwieser1; Monika Brüggemann2; Marco Herling1; Uwe Platzbecker1;

Vladan Vucinic1

1Universitätsklinikum Leipzig, Medizinische Klinik I, Klinik und Poliklinik für

Hämatologie, Zelltherapie, Hämostaseologie und Infektiologie, Leipzig,

Deutschland

2Universitätsklinikum Schleswig-Holstein, Hämatologie Labor Kiel, Sektion für

hämatologische Spezialdiagnostik, Kiel, Deutschland

Background: AlloHSCT is a potentially curative option for pts with high-

risk or relapsed & refractory (r/r) standard-risk ALL. e conventional

myeloablative or reduced intensity regimens cannot be applied to comor-

bid and elderly pts, rendering NMA conditioning for this cohort the only

available mode of alloHSCT.

Methods: We analyzed 28 pts (median age at alloHSCT 60 [range 23-71]

years undergoing alloHSCT aer NMA conditioning between 2004 and

2018. 18 pts were in rst complete remission (CR), nine in CR2, and one

was not in remission. Nine pts were Philadelphia Chromosome positive

(Ph+). Measurable residual disease (MRD) was available for 22 pts of

which 13 were MRDpos before alloHSCT. MRD in Ph+ pts was assessed by

polymerase chain reaction (PCR) for BCR::ABL1 gene in Ph+, and with

immunoglobulin/T-cell receptor rearrangement in Ph-. e median fol-

low-up aer alloHSCT was 3084 (166-5694) days.

Result: Progression-free survival (PFS) and overall survival (OS) for all

pts were 291.5 (6-5694) and 984 (6-5694) days, respectively. Aer one

year, cumulative relapse incidence and non-relapse mortality (NRM)

were 17.8% and 35.7%, respectively. Ph+ pts showed superior median OS

with 1260 (352-5286) and 300 (6-5694) days (p=0.04), but no dierences

in median PFS with 192 (6-5694) and 1002 (75-4384) days, respectively

(p=0.23). We detected no dierences regarding OS and PFS regarding

MRD status (p=0.88). Factors like sex (p=0.40), age (p=0.13), GvHD

(p=0.31) did not show signicant inuence on outcomes aer alloHSCT.

Discussion and Conclusion: We demonstrate that NMA alloHSCT is a fea-

sible option for comorbid and elderly pts with ALL, emphasizing the role

of gra-vs-leukemia eect, although showing considerable NRM. We did

not observe the negative prognostic role of MRDpos, probably to the limited

number of patients. Our analysis shows encouraging OS of Ph+ pts.

Disclosure Statement: e authors declare no conict of interest.

121

Development of a Modular Patient-Reported Outcomes Tool

on Patient Needs and Benets in CLL (PBI-CLL)

Beke Hester1; Helen Beckmann2; Julia von Tresckow3; Minna Voigtlaender1;

Manfred Welslau4; Christine Blome1

1Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland

2AstraZeneca GmbH, Hamburg, Deutschland

3Universitätsklinikum Essen, Essen, Deutschland

4MVZ am Klinikum Aschaenburg, Aschaenburg, Deutschland

Background: Chronic lymphocytic leukemia (CLL) is the most common

form of leukemia in adults in western countries. Numerous new treatment

options underline the importance of considering individual patient needs in

treatment decision making. To date, no instrument exists to capture these

needs. is project aims to develop an electronic Patient-Reported Outcome

Measure (ePROM) that assesses treatment goals and benets in CLL.

Methods: e ePROM will be developed based on the Patient Benet

Index (PBI) methodology which captures importance and achievement of

treatment goals. e PBI-CLL will introduce three modules on treatment

preferences: general preferences, process quality, and therapy outcomes.

Qualitative interviews with an anticipated n=30 participants will be con-

ducted to capture treatment goals and disease burden in CLL; in addition,

free-text questionnaires will be completed. Based on qualitative content anal-

ysis according to Kuckartz, a dra version of the PBI-CLL will be developed

in an expert panel and will be adapted aer cognitive debrieng interviews.

Result: To date, 28 interviews have been conducted; we expect comple-

tion of data collection and analysis by the end of 2023. Preliminary results

show that the individual burden of CLL varies widely; some patients

reported high, others low impact on their mental health. Patients reported

dierent treatment goals, for example preferences in the administration

method and site. Patients also wished for empathic hematologists who

provide them with ample information about their disease and the treat-

ment options. Overall, CLL patients wanted a treatment that allows them

to live normally with few limitations through their disease or treatment.

Discussion: e preliminary results show that burdens and treatment

goals in CLL vary considerably between patients which underlines the

heterogeneity of this patient group.

Conclusion: e ndings conrm the importance of a new instrument

measuring treatment goals and benets in a standardized way which can

be utilized in both routine care and clinical studies.

Disclosure Statement: e authors declare the following: this study is conducted

in cooperation with and funded by AstraZeneca.

186

Gene Expression Clusters in the JAK-STAT Pathway in

Adolescent and Young Adults (AYA) and Non-AYA Patients

with BCR::ABL Negative Myeloproliferative Neoplasm (MPN)

– Results of MAry, a multicenter project of the East German

Study Group for Hematology and Oncology (OSHO)

Alice Diepers1; Susann Schulze1,2; Nadja Jäkel3; Danny Misiak4; Christina

Zahn3; Claudia Spohn5; Regina Moeller5; Dietrich Kämpfe6; Maik Schwarz7;

Katrin Nerger8; Bayram Edemir8; Haifa Al-Ali1

1Krukenberg Cancer Center Halle, University Medicine Halle, Halle (Saale),

Deutschland

2Carl-von-Basedow-Klinikum Saalekreis, Department of Medicine Clinic II, Halle

(Saale), Deutschland

3University Clinic and Outpatient Clinic for Internal Medicine IV, University

Hospital Halle, Halle (Saale), Deutschland

4Institute of Molecular Medicine, University Medicine Halle, Halle (Saale),

Deutschland

5Hämatologisch-Onkologische Gemeinschaftspraxis, Halle (Saale), Deutschland

6Praxis für Hämatologie und Onkologie, Lüdenscheid, Deutschland

7Paracelsus Medizinisches Versorgungszentrum, Schwerpunktpraxis für

Hämatologie und Onkologie, Schoeneck, Deutschland

8University Clinic and Outpatient Clinic for Internal Medicine IV, Medical Faculty

of the Martin Luther University Halle-Wittenberg, Halle (Saale), Deutschland

Background: Phenotype driver mutations (mut) and JAK-STAT dys-

regulation characterize MPN. We studied the expression (Exp) of JAK2,

CALR, STATs in AYAs (<39 y. at diagnosis) and Non-AYA patients (pts)

with BCR::ABL negative (neg) MPN within the Incyte Biosciences funded

MAry project, approved by ethical committees.

Methods: Aer signed informed consent, phenotype data and blood sam-

ples were collected [AYA=45, Non-AYA=77]. Besides whole transcriptome

sequencing (RNA-seq) from blood derived RNA, WES from blood and FACS

sorted CD3+ cells derived DNA was performed. e bioinformatic analyses

were done at the Core Facility Imaging of the MLU Halle-Wittenberg. Merging

of variant and annotation data was performed via an in-house R script.

Results: Median ages of AYAs and Non-AYAs were 33 and 52 y. respectively.

Male/female ratio and MPN duration were comparable. Diagnoses were ET

(44%), PV (27%), PMF (23%), and unclassied MPN (6%). JAK2V617F,

CALR, and MPL mut were detected in 77%, 11%, and 1.7%. 11 (9%) pts

were triple neg. Irrespective of phenotype driver mut or diagnosis, CALR

Exp was neg associated (assoc) to JAK2 Exp (R²=0.3) and was signicantly

higher (p<0.000). In linear regression models, STAT1 Exp was positively

(pos) assoc with STAT2 (R²=6) and STAT3 (R²=0.3). JAK2V617F and CALR

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 113

mut correlated with higher JAK2 and CALR Exp respectively (p=0.02) but

not with STATs Exp. JAK2 Exp was pos assoc with STAT5B and STAT6 Exp

(R²=0.6;p<0.000) and neg related to STAT4 Exp (R²=0.4;p<0.000). CALR

Exp was neg assoc to STAT5B and STAT6 Exp (R²=0.5;p<0.000). In AYAs a

lower JAK2 (p<0.000), STAT5B (p=0.003), and STAT6 (p=0.006) Exp and a

higher CALR (p=0.05) and STAT4 (p<0.000) Exp cluster was seen. A higher

JAK2/STAT5B/STAT6 and a lower STAT4 Exp cluster was signicantly

assoc with thrombotic events and MPN therapy.

Conclusions: Distinct gene Exp clusters in the JAK-STAT pathway are

assoc with certain phenotypic features. Exp quantitative trait locus analy-

ses within MAry will evaluate the association between Exp levels and the

genotype at a SNV locus to provide evidence for a SNV’s regulatory role.

Disclosure Statement: e authors declare the following: HKA-A: Research

support from Novartis, Bristol Myers Squibb and Incyte, Participating on a

scientic advisory board for Novartis, Bristol Myers Squibb, Abbvie, SGK, Blue

Print, AOP Pharma; Travel grant from Novartis, Bristol Myers Squibb and Abbvie;

MS: Travel grant from Janssen, Servier, AstraZeneca

260

Cumulative Review of Hypertension (HTN) in Patients With

Chronic Lymphocytic Leukemia (CLL) and Other Hematologic

Malignancies Treated With Acalabrutinib

Stephan Stilgenbauer1; Alessandra Ferrajoli2; George Follows3; Yotvat

Marmor4; Shogheeg Apkarian Bourjlian5; Jack Roos5; Naghmana Bajwa5;

Venkata Madhira6; Kenji Nozaki7; Paulo Miranda5; Krish Patel8

1University of Ulm, Ulm, Deutschland

2University of Texas MD Anderson Cancer Center, Houston, USA

3Addenbrookes Hospital, Cambridge, United Kingdom

4AstraZeneca, South San Francisco, USA

5AstraZeneca, Gaithersburg, USA

6AstraZeneca, Wilmington, USA

7AstraZeneca, Osaka, Japan

8Swedish Cancer Institute, Seattle, USA

Background: Here, we performed a cumulative analysis of new or wors-

ening HTN from the acalabrutinib (A) global development program and

compared these data against reported prevalence and incidence of HTN

for pts with CLL in real-world and clinical trials.

Methods: Safety reports of new or worsening HTN were obtained from 11

clinical trials with A monotherapy (mono). or in combination with obinu-

tuzumab (O)) and active comparators. Using the Standardized MedDRA

Query and the related MedDRA preferred terms for “HTN,” exposure-ad-

justed incidence rates (EAIRs) in events/100 person-years were determined,

and HTN prevalence was assessed at median treatment exposure for A

mono. HTN prevalence was also assessed from 3 closed claims databases.

Result: e prevalence of HTN ranged from 47.3% to 66.1% in pts with TN

CLL prior to treatment initiation. HTN prevalence with A mono at 45.5

months (mos) of exposure was 55.7%. EAIRs of HTN were analyzed from

11 clinical trials; 1225 pts received A mono (947with CLL), 223 pts A + O

(all with CLL), 264 pts ibrutinib (I) as a comparator (all with CLL), and 322

pts other comparators (all with CLL). Among the 1225 pts treated with A

mono, 165 pts (147 with CLL) had treatment emergent HTN (59.4% [n=98]

with history of HTN at baseline). e EAIRs of HTN with A mono (3.844)

and A + O (3.926) were similar to that of other comparators (4.788 [exclud-

ing ibrutinib]). In ELEVATE-RR study specically, the EAIR of HTN with

A (3.053) was approximately one-third that of I (8.590). EAIR of HTN in pts

treated with A mono without history of HTN was 3.239.

Discussion: HTN is a common comorbidity in CLL pts as demonstrated

in claims database and clinical trial database analyses. Incidence rates of

new or worsening HTN with A mono and A + O were low. is is sup-

ported by similar incidence proportion of new or worsening HTN in pts

receiving placebo (8.3%) from CLL12 (median follow-up 69.3 mos) and A

mono (8.9%) from ELEVATE-TN (median follow-up 58.2 mos).

Conclusion: Our analysis suggests that A mono did not worsen pre-exist-

ing HTN or increase the risk of new-onset HTN.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

278

Acalabrutinib ± Obinutuzumab (A, A+O) vs Obinutuzumab

+ Chlorambucil (O+Clb) in Treatment-Naive Chronic

Lymphocytic Leukemia: 6-Year Follow-Up of ELEVATE-TN

Uwe M. Martens1, Je Sharman2, Miklos Egyed3, Wojciech Jurczak4, Alan

Skarbnik5, Krish Patel6, Ian W Flinn7, Manali Kamdar8, Talha Munir9,

Renata Walewska10, Marie Hughes11, Laura Maria Fogliatto12, Yair

Herishanu13, Versha Banerji14, George Follows15, Patricia Walker16, Karin

Karlsson17, Paolo Ghia18, Ann Janssens19, Florence Cymbalista20, John C.

Byrd21, Emmanuelle Ferrant22, Alessandra Ferrajoli23, William G. Wierda23,

Jennifer A. Woyach21

1Clinic for Hematology, Oncology and Palliative Care, SLK Kliniken Heilbronn,

Heilbronn, Deutschland

2Willamette Valley Cancer Institute and Research Center/US Oncology Research,

Eugene, USA

3Somogy County Mór Kaposi General Hospital, Kaposvár, Ungarn

4Maria Skłodowska-Curie National Research Institute of Oncology, Krakau, Polen

5Novant Health Cancer Institute, Charlotte, USA

6Swedish Medical Center, Seattle, USA

7Sarah Cannon Research Institute, Nashville, USA

8University of Colorado Cancer Center, Aurora, USA

9Haematology, Haematological Malignancy Diagnostic Service (HMDS), St.

James’s Institute of Oncology, Leeds, United Kingdom

10Cancer Care, University Hospitals Dorset, Bournemouth, United Kingdom

11Tauranga Hospital, Tauranga, Neuseeland

12Hospital de Clinicas de Porto Alegre, Porto Alegre, Brasilien

13Tel Aviv Sourasky Medical Center - Ichilov, Tel Aviv-Yafo, Israel

14Departments of Internal Medicine, Biochemistry & Medical Genetics, Max Rady

College of Medicine, Rady Faculty of Health Sciences, University of Manitoba

and CancerCare Manitoba, Winnipeg, Kanada

15Department of Haematology, Addenbrooke’s Hospital NHS Trust, Cambridge,

United Kingdom

16Peninsula Health and Peninsula Private Hospital, Frankston, Langwarrin,

Australien

17Skåne University Hospital Lund, Lund, Schweden

18Università Vita-Salute San Raaele and IRCCS Ospedale San Raaele, Milano,

Italien

19University Hospitals, Leuven, Belgien

20Bobigny: Hématologie, CHU Avicennes, Bobigny, France, Bobigny, Frankreich

21The Ohio State University Comprehensive Cancer Center, Columbus, USA

22Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Service d’Hématologie

Clinique, Pierre-Bénite, Frankreich

23University of Texas MD Anderson Cancer Center, Houston, USA

Background: Herein, we report updated results at 74.5 mo of follow-up of

the ELEVATE-TN trial.

Methods: Pts were randomized to A+O, A, or O+Clb. Pts with progres-

sion on O+Clb could cross over to A mono. Investigator-assessed (INV)

progression-free survival (PFS), INV overall response rate, overall sur-

vival (OS), and safety were evaluated.

Result: A total of 535 pts (A, n=179; A+O, n=179; O+Clb, n=177) had a

median age of 70 y, 63% had unmutated IGHV (uIGHV), and 14% had

del(17p) and/or TP53 mutation (TP53m). At a mFU of 74.5 mo (data cut-

o MAR 3, 2023), median PFS (mPFS) was not reached (NR) for A+O

and A vs 27.8 mo for O+Clb (hazard ratio [HR] vs O+Clb: 0.14 and 0.23,

respectively; P<0.0001 for both; HR A+O vs A: 0.58; P=0.0229). Median

OS (mOS) was NR in any arm and was signicantly longer with A+O

vs O+Clb (HR: 0.62; P=0.0349). In 337 pts with uIGHV, mPFS was NR

for A+O and A vs 22.2 mo for O+Clb (HR: 0.08 and 0.12, respectively;

P<0.0001 both). In 73 pts with del(17p) and/or TP53m, mPFS was 73.1

mo for A+O and NR for A vs 17.5 mo for O+Clb (HR: 0.28 and 0.23,

respectively; P≤0.0009 both). mOS was NR for A+O and A vs 74.9 mo for

O+Clb (HR: 0.53 and 0.46, respectively, neither statistically signicant).

Adverse events (AEs) for O+Clb have been previously reported. Most

common (≥5%) gr. ≥3 AEs for A+O and A, respectively, were neutrope-

nia (31%/12%), thrombocytopenia (8%/3%), diarrhea (6%/1%), COV-

19 (9%/7%), pneumonia (7%/6%), syncope (5%/ 2%), and hypertension

(HTN) (4%/5%). For events of clinical interest, gr. ≥3 atrial brillation,

HTN, and secondary primary malignances were reported in 2%, 4%, and

10% with A+O and 2%, 5%, and 5% with A, respectively. e most com-

mon reasons for treatment discontinuation were AEs, in 21% (n=38) with

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts114

A+O and 18% (n=32) with A, and progressive disease, in 6% (n=10) with

A+O and 14% (n=25) with A.

Discussion: With mFU of 74.5 mo, the ecacy and safety of A+O and A

mono were maintained in pts with TN CLL, including in pts with high-

risk genetics.

Conclusion: At 6 years of FU, PFS was signicantly longer with A+O vs

A. mOS was NR in any study arm and was signicantly longer with A+O

vs O+Clb.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

308

Multiple Myeloma Registry of the East German Study Group

Hematology/Oncology (OSHO): updated analysis of rst and

second lines' treatment results

Sebastian Böttcher1; Brigitte Kragl1; Maximillian Merz2; Gabriele

Prange-Krex3; Martin Schmidt-Hieber4; Harald Schmalenberg5; Lars-Olof

Muegge6; Christoph Kimmich7; Anke Gerhardt8; Christian Scholz9;

Beate Krammer-Steiner10; Andreas Schwarzer11; Dietrich Kämpfe12;

Franziska Brunner13; Ulrike Triegla14; Christoph Kahl15; Inessa Paulenz16;

Philipp Kiewe17; Philipp Hemmati18; Mathias Hänel19; Detlev Hähling20;

Malte Leithäuser21; Susann Schulze22; Ulrich Ingo Langenkamp1;

Christian Junghanß1

1Universitätsmedizin Rostock, Zentrum für Innere Medizin, Medizinische Klinik

III - Hämatologie, Onkologie, Palliativmedizin, Rostock, Deutschland

2Uniklinikum Leipzig, Klinik und Poliklinik für Hämatologie, Leipzig, Deutschland

3Gemeinschaftspraxis für Hämatologie und Onkologie, Dresden, Deutschland

4Carl-Thiem-Klinikum, 2. Medizinische Klinik, Hämatologie/Onkologie, Cottbus,

Deutschland

5Städtisches Klinikum Dresden, IV. Med. Klinik - Hämatologie, Dresden,

Deutschland

6Heinrich-Braun-Klinikum, Innere Med. III – Zwickau, Deutschland

7Klinikum Oldenburg AöR, Universitätsklinik für Innere Medizin - Onkologie und

Hämatologie, Oldenburg, Deutschland

8Schwerpunktpraxis für Hämatologie und Onkologie Dr. A. Gerhardt, Dr. H.

Linde, B.Matthes, Potsdam, Deutschland

9Vivantes, Klinikum am Urban, Innere Medizin - Hämatologie und Onkologie,

Berlin, Deutschland

10Klinik für Hämatologie,Onkologie,Hämostaseologie, Komplementär-und

Palliativmedizin, Rostock, Deutschland

11Onkopraxis Probstheida, Leipzig, Deutschland

12Praxis für Hämatologie und Onkologie, Lüdenscheid, Deutschland

13Klinik für Innere Medizin IV Onkologie/Hämatologie Universitätsklinikum

Halle/Saale, Halle/Saale, Deutschland

14Gemeinschaftspraxis Dr. Gröpler/Triegla, Wismar, Deutschland

15Klinikum Magdeburg gGmbH, Klinik für Hämatologie/Onkologie, Magdeburg,

Deutschland

16Städtisches Klinikum Dessau, Klinik für Innere Medizin - Hämatologie/

Onkologie, Dessau, Deutschland

17MVZ Onkologischer Schwerpunkt am Oskar-Helene-Heim, Berlin, Deutschland

18Dietrich-Bonhoeer-Klinikum Neubrandenburg, Klinik für Hämatologie,

Onkologie und Immunologie, Neubrandenburg, Deutschland

19Klinikum Chemnitz gGmbH, Innere Medizin III, Hämatologie / Onkologie /

Stammzelltransplantation, Chemnitz, Deutschland

20Schwerpunktpraxis Onkologie / Hämatologie, Schwerin, Deutschland

21Gemeinschaftspraxis für Onkologie, Rostock, Deutschland

22Carl-von-Basedow Klinikum Saalekreis gGmbH, Zentrum für Innere Medizin,

Medizinische Klinik III, Merseburg, Deutschland

Background: Modern therapies in multiple myeloma (MM) have been

licensed based on prospective trials, which might not fully reect daily

treatment practice. e OSHO MM registry (OSHO trial #89) aims to

investigate patients (pts) in real world settings (focus: ecacy, safety,

treatment sequences, and MRD).

Methods: As of August 1, 2023, 805 pts from 28 centers were included.

Le over samples could be assessed for MRD using next generation ow

cytometry with a sensitivity of 10-5 at a central laboratory.

Result: Most pts (median age 70 years (range, 37-90)) presented with

IgG MM (58%), followed by light chain MM (21%), IgA MM (20%) and

non-secretory MM (1%). 21% of all pts carried high risk cytogenetic

aberrations (del17p, t(4;14), t(14;16)) whereas ampl 1q21 was observed in

28%, t(11;14) in 18%, and hyperdiploidy in 27%. PFS and OS analyses were

restricted to 299 pts with a prospectively documented minimum follow up

of 6 months (mos) on rst (1L, n=234) or second (2L, n=101) line treat-

ments (median follow up 11 mos). Out of 234 1L pts, 76 pts received an

autologous stem cell transplantation (SCT). A median PFS of 46 mos was

observed in pts treated with SCT whereas 158 pts who received therapies

without SCT experienced a shorter PFS (26 mos, p<0.001). Accordingly,

OS diered signicantly (NR vs 35 mos, p < 0.0001). Transplant eligible pts

were younger than transplant ineligible pts (63 vs 77 years). In pts treated

without SCT, 40 received an induction based on a proteasome inhibitor

(PI), whereas an additional 35 pts were treated with PI-antibody com-

binations (mPFS 19 vs 22 mos, ns). PFS was similar in pts who received

an IMID based 1L treatment irrespective of the addition of an antibody

(10 vs 59 pts, 26 mos vs NR, ns). Prospectively documented 2L treatment

from 101 pts resulted in a median PFS of 26 mos.

Discussion: Due to still limited follow up these preliminary real world

data should be interpreted with caution. Updated data will be presented

at the conference.

Conclusion: OSHO MM registry analysis corroborates the role for SCT

in the 1L treatment of multiple myeloma in the era of targeted therapies.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

315

Novel Telmisartan derivatives as add-on agents to circumvent

Imatinib resistance in CML

Maximilian Gebhart1; Stefan Salcher2; Ronald Gust1

1Universität Innsbruck - Campus Innrain, Innsbruck, Österreich

2Medizinische Universität Innsbruck, Innsbruck, Österreich

Background: Chronic myeloid leukemia (CML) is a myeloprolifera-

tive disease caused by the mutation and proliferation of a monoclonal

multipotent hematopoietic progenitor cells. Resulting gene products

show a dysregulated tyrosine kinase activity [1]. Nowadays, targeted ther-

apy of CML with tyrosine kinase inhibitors (TKIs) is available. However,

TKIs frequently fail to completely eradicate the disease since quiescent

leukemic stem cells (LSCs) are highly insensitive to therapy. erefore,

the disease persists in a signicant number of patients. Previous studies

by our group indicated that TKI-resistant LCSs can be eciently targeted

by a combination therapy of Imatinib and the angiotensin 2 antagonist

Telmisartan [2,3]. Based on these promising ndings, we aimed to opti-

mize the chemical structure of Telmisartan.

Methods: To evaluate the activity and selectivity of the developed com-

pounds we performed a modied MTT assay with wild type K562

CML cells and their respective imatinib resistant subclone K562-R.

Furthermore, the mode of action was investigated by ow cytometry and

immunoassays. We also performed ADME studies to analyze the pharma-

cokinetic properties of the new compounds.

Result: With the new compounds, we could increase the cytotoxic activ-

ity of Imatinib on resistant CML cells from 10% to >90%. In addition,

the compounds are per se non-cytotoxic on non-malignant cell lines. We

could discover a unique mode of action while also partially retaining the

pharmacokinetic properties of Telmisartan.

Discussion: With the structural modications we could increase the activity

10-fold compared to Telmisartan while retain their selectivity. e ADME

studies showed that still some structural improvements can be made.

Conclusion: We obtained a better understanding of the pharmacokinetic

and pharmacodynamic properties of the novel compounds which pro-

vides the basis for future in vivo studies.

Indication of source:

[1] Soetzer O J et al, Dtsch Med Wochensch 2002; 127:2618–2620.

[2] Prost S et al, Nature 2015; 525(7569); 380–383.

[3] Schöpf A et al, Med Chem 185(2020) 111748.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 115

318

Quality of Life with Nivolumab and AVD First-Line Treatment

in Hodgkin Lymphoma: Patient-Reported Outcomes from the

Phase II GHSG NIVAHL Trial

Paul J. Bröckelmann1; Ina Bühnen1; Peter Herhaus2; Julia Meissner3; Karolin

Trautmann4; Horst Müller1; Michael Fuchs1; Bastian von Tresckow5; Peter

Borchmann1; Andreas Engert1; Karolin Behringer1

1Uniklinik Köln, Klinik I für Innere Medizin, Deutsche Hodgkin Studiengruppe

(GHSG), Köln, Deutschland

2Klinikum Rechts der Isar, Technische Universität München, Innere Medizin III,

München, Deutschland

3Uniklinik Heidelberg, Medizin V, Heidelberg, Deutschland

4Uniklinik Carl Gustav Carus Dresden, Technische Universität Dresden, Dresden,

Deutschland

5Uniklinik Essen, Klinik für Hämatologie und Stammzelltransplantation,

Deutsche Hodgkin Studiengruppe (GHSG), Essen, Deutschland

Background: First-line treatment with nivolumab (N) in combination

with AVD chemotherapy is highly eective in Hodgkin lymphoma (HL).

Herein, we present the preplanned analysis of quality of life (QoL), fatigue

and life situation of the randomized GHSG phase II NIVAHL trial.

Methods: NIVAHL enrolled 109 patients with early-stage unfavorable

HL to receive either fully concomitant (4xN-AVD; group A) or sequen-

tial (4xN, 2xN-AVD, 2xAVD; group B) 1st-line treatment, each followed

by 30Gy IS-RT (Bröckelmann JCO 2023). Patients reported QoL and

fatigue by the EORTC QLQC30 questionnaire in addition to key socio-

demographic data. Data were analyzed descriptively and time-to-recov-

ery (TTR) calculated for resolution of fatigue (TTR-F) and return to work

(TTR-W).

Results: In a total of 99 evaluable patients, mean fatigue score was 22

points higher (95%CI 16.1-27.9) than the age- and sex-matched German

reference population at baseline, worsened during treatment (+38.2,

95%CI 31.4-44.9) but improved to normal values at 3-year FU (-3.4,

95%CI -10.7 to 3.9). Similar trajectories were observed for global health

status/QoL as well as the dierent functional and symptom scales. While

improvement beyond baseline (79.6, 95%CI 76.5-82.7, out of a max. score

of 100) was observed, global health status/QoL did not improve to age-

and sex-matched reference values at 1- (87.2, 95%CI 83.2-91.2) and 3-year

FU (92, 95%CI 87.8-96.2). Multiple regression analysis showed a signi-

cant eect of baseline score (ß 0.28-0.56) and age (ß 0.23-0.34) on cog-

nitive, emotional and social functional scales as well as fatigue at 1-year

of FU. Median TTR-F and TTR-W were 12.8 (95%CI 7.3-20.3) and 3.8

months (95%CI 1.4-8.0) aer EOT, respectively.

Discussion: is is the rst ever analysis of patient-reported outcomes

aer anti-PD1 based rst-line HL treatment.

Conclusion: Substantial fatigue and impaired global QoL status existing

at baseline relevantly improve aer nivolumab-based 1st-line treatment.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

335

Mezigdomide (MEZI) plus dexamethasone (DEX) and

bortezomib (BORT) or carlzomib (CFZ) in patients (pts) with

relapsed/refractory multiple myeloma (RRMM): results from

the CC-92480-MM-002 trial

Marc S Raab1; Albert Oriol2; Irwindeep Sandhu3; Darrell White4;

Richard Leblanc5; Noopur Raje6; Enrique M. Ocio7; Aurore Perrot8;

Thierry Facon9; Cesar Rodriguez10; Ralph Wäsch11; Michael Amatangelo12;

Zehua Zhou12; Yue Wang12; Tiziana Civardi13; Phillip Koo12; Paulo Maciag12;

Daniell Zhu12; Jessica Katz12; Paul G. Richardson14

1Universitätsklinikum Heidelberg, Heidelberg, Deutschland

2Catalan Institute of Oncology and Josep Carreras Institute, Hospital Germans

Trias i Pujol, Badalona, Spanien

3University of Alberta, Edmonton, Kanada

4Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax,

Canada

5Hôpital Maisonneuve-Rosemont, Université de Montréal, Montreal, Canada

6Massachusetts General Hospital, Boston, USA

7Hospital Universitario Marqués de Valdecilla (IDIVAL), Santander, Spanien

8Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, Frankreich

9Centre Hospitalier Universitaire (CHU) Lille, Service des Maladies du Sang,

University of Lille, Lille, Frankreich

10Icahn School of Medicine at Mount Sinai, New York, USA

11Department of Medicine, University of Freiburg Medical Center, Freiburg,

Deutschland

12Bristol Myers Squibb, Princeton, USA

13Celgene International Sàrl, a Bristol-Myers Squibb Company, Boudry, Schweiz

14Dana-Farber Cancer Institute, Boston, USA

Background: In the CC-92480-MM-002 trial (NCT03989414), MEZI had

promising ecacy and safety with DEX + BORT (MeziVd) and DEX +

CFZ (MeziKd) in RRMM pts. In phase 1, a 1.0mg dose + Vd (MeziVd-

1.0mg) was selected for further investigation. Here we report updated

results from the MeziVd and MeziKd dose-escalation cohorts and the

MeziVd-1.0mg dose-expansion cohort.

Methods: Eligible pts had: RRMM, 2–4 (MeziVd and MeziKd cohorts) or

1–3 (MeziVd-1.0mg cohort) prior regimens including lenalidomide, and

progressive disease during or aer last myeloma therapy. MEZI was given

at escalating doses (0.3, 0.6, 1.0mg) or at 1.0mg on days (D)1–14 of each

21-D cycle with Vd, or at escalating doses on D1–21 of each 28-D cycle

with Kd. Primary objectives were to determine the recommended dose

and regimen and to evaluate safety and ecacy.

Result: As of March 20, 2023, 28 pts received MeziVd, 38 MeziVd-1.0mg,

and 27 MeziKd. Across all cohorts, 65.8–88.9% pts were IMiD® agent

refractory, 18.4–51.9% pts were proteasome inhibitor (PI) refractory,

and 36.8–74.1% pts were anti-CD38 monoclonal antibody refractory;

median follow-up was 10.8–13.2 mo. e most frequent grade 3‒4 treat-

ment-emergent adverse events were neutropenia (35.7%) and thrombocy-

topenia (21.4%) with MeziVd; neutropenia (57.9%) and infections (34.2%)

with MeziVd-1.0mg; and neutropenia (40.7%) and infections (29.6%)

with MeziKd. Overall response rate was 75.0% with MeziVd; 84.2% with

MeziVd-1.0mg; and 85.2% with MeziKd. Median duration of response

was 10.4 and 11.9 mo in the MeziVd and MeziKd cohorts (MeziVd-1.0mg

cohort: not reached). MEZI had pharmacodynamic activity with BORT/

CFZ at all doses tested, with 1.0mg inducing the greatest substrate degra-

dation and T cell proliferation.

Discussion: With longer follow-up, MeziVd and MeziKd continued to

show promising ecacy with a manageable safety prole in RRMM pts.

Conclusion: Dose optimization of MEZI + DEX in combination with PIs

continues to be explored; these data support further exploration in phase

3 studies.

Prev. presented

First published: Oriol A et al. CLML 2023;23[suppl]:OA-49.

Disclosure Statement: e authors declare that there are conicts of interest.

econicts were submitted to the congress organizer KUKM GmbH and KUKM

can disclose them if needed.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts116

336

Luspatercept versus epoetin alfa (EA) for treatment (tx) of

anemia in ESA-naive lower-risk myelodysplastic syndromes

(LR-MDS) patients (pts) requiring RBC transfusions (RBCT):

data from the phase 3 COMMANDS study

Uwe Platzbecker1; Matteo Giovanni Porta2,3; Valeria Santini4; Amer M.

Zeidan5; Pierre Fenaux6; Rami S. Komrokji7; Jake Shortt8; David Valcárcel9;

Anna Jonášová10; Sophie Dimicoli-Salazar11; Ing Soo Tiong12; Chien-Chin

Lin13; Jiahui LI14; Jennie Zhang14; Ana Carolina Giuseppi14; Sandra Kreitz15;

Veronika Pozharskaya14; Karen L. Keeperman14; Shelonitda Rose14; Jeevan

K. Shetty15; Sheida Hayati14; Sadanand Vodala14; Andrius Degulys16,17;

Stefania Paolini18; Thomas Cluzeau19; Guillermo Garcia-Manero20

1Medical Clinic and Policlinic 1, Hematology and Cellular Therapy, University

Hospital Leipzig, Leipzig, Deutschland

2Cancer Center IRCCS Humanitas Research Hospital, Milan, Italien

3Department of Biomedical Sciences, Humanitas University, Milan, Italien

4MDS Unit, Hematology, University of Florence, AOUC, Florence, Italien

5Department of Internal Medicine, Yale School of Medicine and Yale Cancer

Center, Yale University, New Haven, USA

6Hôpital Saint-Louis, Paris, Frankreich

7Mott Cancer Center, Tampa, USA

8Monash University and Monash Health, Melbourne, Australien

9Hospital Universitari Vall d’Hebron, Barcelona, Spanien

10Charles University General University Hospital, Prague, Tschechische Republik

11Hôpital Haut-Lévêque, Centre, Hospitalier Universitaire de Bordeaux,

Bordeaux, Frankreich

12Malignant Haematology & Stem Cell Transplantation, The Alfred, Melbourne,

Australien

13Department of Laboratory Medicine, National Taiwan University Hospital,

Taipei, Taiwan

14Bristol Myers Squibb, Princeton, USA

15Celgene International Sàrl, a Bristol-Myers Squibb Company,

Boudry, Schweiz

16Hematology, Oncology and Transfusion Medicine Center, Vilnius University

Hospital Santaros Klinikos, Vilnius, Lithuania

17Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius,

Lithuania

18IRCCS University Hospital of Bologna, “Seràgnoli” Institute of Hematology,

Bologna, Italien

19Département d’Hématologie Clinique, Université Côte d’Azur, CHU Nice, Nice,

Frankreich

20Department of Leukemia, University of Texas M.D. Anderson Cancer Center,

Houston, USA

Background: ere is a need for tx of anemia due to LR-MDS. We

show interim ecacy and safety results from the phase 3, open-label

COMMANDS trial (NCT03682536) comparing luspatercept vs EA in pts

with ESA-naive LRMDS.

Methods: Pts were ≥18 y, had sEPO < 500 U/L, required RBCTs. Pts

received luspatercept (1.0–1.75 mg/kg; Q3W) or EA (450–1050IU/kg;

Q1W) for ≥ 24 wk. Pts were stratied by baseline RBCT burden, sEPO,

and ring sideroblast (RS) status. Primary endpoint was RBC-TI ≥ 12 wk

with concurrent mean Hb increase ≥ 1.5 g/dL (wk 1–24). Secondary end-

points included HIE ≥ 8 wk, RBCTI 24 wk, and ≥ 12 wk (wk 1–24), sub-

group analyses, response impact of MDS-related gene mutations, safety.

Result: 178 pts were randomized to luspatercept and 178 to EA (31 Aug

2022); median tx durations were 41.6 and 27.0 wk. 86/147 (58.5%) lus-

patercept- and 48/154 (31.2%) EA-treated pts achieved the primary end-

point (P < 0.0001); primary endpoint achievement favored luspatercept

or was similar to EA for all subgroups. Luspatercept tx favored achieving

HI-E ≥ 8 wk, RBC-TI 24 wk, and ≥ 12 wk (wk 1–24). Median RBC-TI ≥

12 wk duration was longer with luspatercept vs EA (126.6 vs 77.0 wk),

and for relevant subgroups, including RS+/−. Pts with SF3B1, SF3B1α,

ASXL1, and TET2 mutations had favorable luspatercept response vs EA.

164 (92.1%) luspatercept and 150 (85.2%) EA pts reported tx-emergent

adverse events (TEAEs); 8(4.5%) and 4 (2.3%) pts, respectively, discontin-

ued due to TEAEs. Most common TEAEs with luspatercept were fatigue

(14.6%), diarrhea (14.6%), hypertension (12.9%), and with EA these were

asthenia (14.2%), diarrhea (11.4%), anemia (9.7%); most TEAEs were

mild/moderate. 4(2.2%) luspatercept and 5 (2.8%) EA pts progressed to

AML; death rates were similar (32[18.0%] vs 32 [18.2%]).

Discussion: Luspatercept demonstrated superiority vs EA with clinically

meaningful RBC-TI and HI-E improvements, favorable outcomes across

MDS mutations, and safety comparable with previous reports.

Conclusion: Luspatercept may be a new tx standard in LR-MDS.

First published: Della Porta MG et al. HemaSphere 2023;7[S3]:S102.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

343

A matching-adjusted indirect comparison (MAIC) of

acalabrutinib (A) with and without obinutuzumab (O) versus

zanubrutinib (Z) in treatment-naïve chronic lymphocytic

leukemia

Frederik Damm1; John N Allan2; Adam S. Kittai3; Dan James4;

Helen Bridge5; Miguel Miranda5; Alan S. M. Yong6; Fady Fam5; Jack Roos6;

Vikram Shetty6; Alan Skarbnik7; Matthew S. Davids8

1Department of Hematology, Oncology, and Cancer Immunology,

Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin

and Humboldt-Universität zu Berlin, Berlin

2Weill Cornell Medical Center, New York, USA, New York, USA

3Division of Hematology, The Ohio State University Comprehensive Cancer

Center, Columbus, OH, USA, Columbus, USA

4Polaris Biostatistics Ltd., Edinburgh, UK, Edinburgh, United Kingdom

5AstraZeneca, Cambridge Biomedical Campus, Cambridge, UK, Cambridge,

United Kingdom

6AstraZeneca, Gaithersburg, MD, USA, Gaithersburg, USA

7Novant Health Cancer Institute, Lymphoma and CLL Program, Charlotte, NC,

USA, Charlotte, USA

8Dana-Farber Cancer Institute, Boston, USA

Background: A and Z have not been compared in head-to-head rand-

omized controlled trial (RCT). We used unanchored MAIC to compare

ecacy/safety of A w/wo O vs. Z in pts with untreated CLL/SLL.

Methods: Individual patient data (IPD) for AO and A arms from

ELEVATE-TN (E-TN) were matched to Z baseline data from cohort 1

of the SEQUOIA RCT. We excluded pts with del(17p) in E-TN to ensure

comparability. Investigator-assessed PFS (INV PFS) was evaluated in pts

with baseline data (AO, n=162; A, n=163; Z, n=241) using Oct 21 data

cut-o (DCO) for E-TN and Oct 22 DCO for SEQUOIA (mFU 58 vs. 44

mo). Matching was based on age, ECOG, Binet stage, bulky disease, b2m,

cytopenia, del(11q), tri12, IGHV and TP53m. Pseudo-IPD for INV PFS

for Z derived from K-M curves. Odds ratios (ORs) of AEs in treated pts

(AO, n=162; A, n=162; Z, n=240) were assessed. To compare the incidence

of AEs, E-TN Sep 20 DCO was used to match the mFU from SEQUOIA

Oct 22 DCO (47 vs. 44 mo).

Result: Eective sample size (ESS) for ecacy was 124 (76%) for AO

and 105 (64%) for A. 36 mo INV PFS was higher with AO (95%; 95% CI:

90–97) than with Z (84%; 95% CI: 79–88), (HR: 0.41; 95% CI: 0.23–0.74).

ere was no dierence for 36 mo INV PFS A(86%; 95% CI: 78–91) vs. Z

(84%; 95% CI: 79–88), (HR: 0.91; 95% CI: 0.53–1.56). ESS for safety was

123 (76%) for AO and 103 (64%) for A. With AO there were no signi-

cant dierences in the odds of having most types of AE, however AO was

associated with higher odds for any grade neutropenia (OR: 2.19; 95% CI:

1.33–3.60) and arthralgia (OR: 2.33; 95% CI: 1.37–3.96) vs. Z. A showed

lower odds for any grade hypertension(HTN) (OR: 0.44, 95% CI: 0.20–

0.99) and no signicant dierences in the odds for other types of AEs vs. Z.

Discussion: In this MAIC AO had longer INV PFS vs. Z, while there was

no evidence of a dierence between A and Z. A was associated with lower

odds of any gr. HTN versus Z. AO was associated with higher odds of any

grade neutropenia and arthralgia vs. Z.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 117

Conclusion: MAIC analyses can only be hypothesis-generating, these

results address an important data gap by comparing these two regimens

where randomized, prospective data are not available.

Disclosure Statement: e authors declare that there are conicts of interest.

econicts were submitted to the congress organizer KUKM GmbH and KUKM

can disclose them if needed.

359

Thiamine-Responsive Megaloblastic Anemia (TRMA)

Syndrome – A Case Presentation

Christina Klötzer1; Anne-Sophie Kubasch1; Madlen Jentzsch2; Jens Uhlig3;

Klaus H. Metzeler1; Franzsika Schnabel4; Johannes Lemke4;

Vladan Vucinic2; Uwe Platzbecker2

1University Leipzig Medical Center, Department of Hematology, Cellular therapy,

Hemostaseology and Infectious Diseases, Leipzig, Deutschland

2University Leipzig Medical Center, Department of Hematology, Cellular therapy,

Hemostaseology and Infectious Diseases, Leipzig, Deutschland

3Hematological Praxis Naunhof, Naunhof

4University Leipzig Medical Center, Clinic for Human Genetics, Leipzig,

Deutschland

Purpose: iamine-responsive megaloblastic anemia syndrome (TRMA)

is a rare autosomal recessive disease with a homozygous or compound-

heterozygous mutation in the SLC19A2 gene characterized by megaloblas-

tic anemia, diabetes mellitus (DM), and sensorineural hearing-loss with

onset in childhood. Folic acid and vitamin B12 in serum are normal with

dysplastic erythropoiesis in the bone marrow oen mimicking myelod-

ysplastic neoplasms (MDN) as a potential dierential diagnosis. Around

200 cases have been described worldwide mainly during childhood. e

substitution of thiamine leads to normalization of anemia, without eects

on hearing-loss or DM. We report here on an adult patient diagnosed with

TRMA with a long history of unexplained anemia.

Methods: e human genetic assessment was performed by molecular

genetic panel diagnostics.

Results: A 38-year-old male Caucasian presented with a 12-year history of

anemia plus insulin dependent DM, optic neuropathy and a cataract since

early childhood. Furthermore, 2019 a drug-eluted stent was placed due to

coronary one-vessel-disease. Prior to presentation in our department, he

received for the rst time two units of red blood cells due to symptomatic

anemia. e laboratory showed megaloblastic anemia with normal white

blood cells and platelet counts. e serum levels of folic acid and vitamin

B12 were normal. e bone marrow smear showed dysplastic erythropoie-

sis with megaloblastic changes, and normal ndings in cytogenetic and

molecular genetic examinations.

A subsequent human genetic evaluation detected a heterozygous variant

in the SLC19A2 gene (c.1001 G>A, p.Gly334Asp) thus conrming the

diagnosis of TRMA. Treatment with oral thiamine 100 mg daily was initi-

ated, and 12 weeks later Hb levels had normalized. A bone marrow smear

demonstrated disappearance of dysplasia.

Discussion: Although extremely rare, TRMA should be included in the

work-up of MDN.

Conclusion: Late-onset TRMA should be considered in adult patients

with indicative comorbidities and a typical phenotype, which may mimic

features of MDS.

Disclosure Statement: e authors declare the following: Novartis, Janssen Cilag,

BMS Celgene, Sobi, Astra Zeneca; Travel Grants: Sobi, Amgen, Gilead,

Janssen, BMS.

437

Simultaneous Inhibition of PI3Kgamma and PI3Kdelta

Deteriorates T-cell Function With Implications for Chronic

Lymphocytic Leukemia

Sebastian Faehling1,2

1DKFZ, Heidelberg, Deutschland

2Medizinische Fakultät Heidelberg, Heidelberg, Deutschland

Background: Chronic lymphocytic leukemia (CLL) remains incurable

even with novel drugs inhibiting crucial enzymes in the B-cell receptor

pathway. Among them, PI3Kδ is conned to leukocytes and constitu-

tively active in CLL making it a promising target. However, non-leukemic

immune cells also rely on PI3K leading to immune-related adverse events

(irAEs) and an impaired function in response to PI3K inhibition.

Methods: We analyzed the in vitro eects of dierent, FDA approved PI3K

inhibitors on T-cells using splenocytes from wildtype and Eµ-TCL1 mice

or human PBMCs from healthy donors and CLL patients. T cells were

stimulated in the presence of the PI3Kδ inhibitors idelalisib and umbral-

isib, the PI3Kγ inhibitor eganelisib, and the dual PI3Kγ and -δ inhibitor

duvelisib, respectively. Aer a preset time, T-cell function and activation

was assessed.

Results: All four PI3K inhibitors reduced T-cell activation and prolifera-

tion. While the single isoform inhibitors were equally eective in murine

T-cells, human T-cells seemed more aected by PI3Kγ inhibition than by

PI3Kδ inhibition. Dual inhibition of PI3Kγ and -δ was even more detri-

mental, suggesting an essential function of both PI3Kγ and -δ in T-cells.

Umbralisib and idelalisib showed no consistent dierences. Interestingly,

the observed eects on T-cells were independent of myeloid cells.

Discussion: Both PI3Kγ and -δ inhibition impairs T-cells which might

explain some of the observed irAEs. While the importance of PI3Kδ for

T-cell function is widely established, PI3Kγ was thought to be less impor-

tant. Our data contradicts this and shows that T-cell function relies on

PI3Kγ and -δ.

Conclusion: Our study showed that PI3Kγ and -δ inhibitors are detrimen-

tal to T-cell function in vitro, and combination of PI3Kγ and -δ inhibition

has strong additive eects.

Indication of source:

1 Faehling et al. Simultaneous Inhibition of PI3Kgamma and PI3Kdelta

Deteriorates T-cell Function With Implications for Chronic Lymphocytic

Leukemia. HemaSphere, 7(3): e840, 2023.

Disclosure Statement: e authors declare no conict of interest.

535

Navigating the (Un-)known – Patients’ Experiences on the Life

Threat Connected to Allogeneic Stem Cell Transplantation

Alinda Reimer1; Carolin Schepers1; Merle Ley1; Berenike Pauli1;

Anne Pralong1; Marco Herling2; Steen T Simon1; Udo Holtick3

1Zentrum für Palliativmedizin der Uniklinik Köln, Köln, Deutschland

2Klinik und Poliklinik für Hämatologie, Zelltherapie, Hämostaseologie und

Infektiologie der Universität Leipzig, Leipzig, Deutschland

3Klinik I für Innere Medizin Onkologie, Hämatologie, Klinische Infektiologie,

Klinische Immunologie, Hämostaseologie, Internistische Intensivmedizin der

Uniklinik Köln, Köln, Deutschland

Background: For patients facing haematological malignancies, allogeneic

stem cell transplantation (allo-SCT) represents an established treatment

option. While oering a high curative potential, the transplantation entails

an elevated risk of mortality as well as high rates of morbidity. A substan-

tial gap exists in the scientic understanding of how patients experience

their existential challenge of confronting their life-threatening condition,

despite the treatment’s curative intent.

Methods: We conducted semi-structured, in-depth interviews with allo-

SCT recipients over the course of their transplantation (before, during,

or aer hospitalization). To systematically analyze interview data, we

employed category-based qualitative content analysis.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts118

Result: Seventeen interviews were conducted. An inclination towards

avoidance of their life threat was emphasized, coupled with a strong focus

on hope for a cure. Challenges arising from a lack of alternative treat-

ments and the uncertain course were further highlighted. Data revealed

that healthcare professionals and the social environment can pose a sup-

portive role. Beyond that, comprehensive information, and knowledge

about the therapeutic course aid in the patients’ ability to deal with the

existential threat.

Discussion: Complex psychological dynamics are revealed, character-

ized by a simultaneous presence of hope for cure and existential fears.

Although patients oen resisted thoughts about these existential threats,

they expressed a strong need for open and honest communication and

information about the treatment course. is highlights the relevance of

healthcare professionals to eectively address these complex emotions and

provide tailored communication.

Conclusion: e ndings emphasize an interplay between hope, avoid-

ance, and psychological distress. To adapt a comprehensive and holistic

approach to treatment, it is desirable to establish avenues for patient edu-

cation and communication, aiming to enhance their ability to cope with

life threat during the treatment course.

Disclosure Statement: e authors declare no conict of interest.

540

Clinical Eectiveness and Safety of Momelotinib Compared

with Continued Ruxolitinib or Best Available Therapy in

Patients with Myelobrosis Who Required Red Blood Cell

Transfusions: Subgroup Analysis of the Phase 3

SIMPLIFY-2 Study

Claire Harrison1; Christoph Scheid2; Alessandro M Vannucchi3; Christian

Recher4; Francesco Passamonti5; Aaron T Gerds6; Juan Carlos Hernández-

Boluda7; Abdulraheem Yacoub8; Shireen Sirhan9; Jun Kawashima10;

Bharat Patel11; Bryan Strouse12; Uwe Platzbecker13

1Guy’s and St Thomas’ Foundation Trust, London, United Kingdom

2Department of Internal Medicine and Center of Integrated Oncology Cologne

Bonn, University of Cologne, Cologne, Deutschland

3University of Florence, Florence, Italy

4University Hospital Center (CHU) of Toulouse, Toulouse, France

5University of Milan Statale, Milan, Italy

6Ceveland Clinic Taussig Cancer Institute, Cleveland, OH, USA

7University of Valencia, Valencia, Spain, Valencia

8University of Kansas, Kansas City, KS, USA

9Jewish General Hospital, McGill University, Montreal, QC, Canada

10Jewish General Hospital, McGill University, Montreal, QC, Canada

11Sierra Oncology, a GSK company, San Mateo, CA, USA

12GSK plc, Philadelphia, PA, USA

13University Hospital Leipzig, Leipzig, Deutschland

Background: To evaluate outcomes in patients (pts) who switched to

Momelotinib (MMB) vs continuing ruxolitinib (RUX) or best available

therapy (BAT) despite transfusion requirement, we present a descriptive

subgroup analysis of pts enrolled in SIMPLIFY-2 (NCT02101268) who

were considered transfusion dependent (TD; ≥4 units of RBC transfusions

in the previous 8 wk or hemoglobin [Hb] level <8 g/dL) or transfusion

requiring (TR; receiving transfusions but not meeting TD criteria) at base-

line (BL).

Methods: SIMPLIFY-2 was an international, multicenter, open-label,

phase 3 clinical trial investigating the ecacy and safety of MMB vs BAT

in pts with MF who had suboptimal responses or hematologic toxicities

while receiving RUX. Pts (N=156) were randomized 2:1 to receive open-

label MMB or BAT, which was RUX in 88.5% of pts. e primary endpoint

was spleen volume reduction ≥35% (SVR35). Total Symptom Score (TSS)

response rate (≥50% reduction; TSS50) and transfusion independence

response (TI-R; no RBC transfusions for ≥12 wk immediately before the

end of wk 24, with all Hb levels ≥8 g/dL) were key secondary endpoints.

Results: In SIMPLIFY-2, 72 of 104 pts (69%) in the MMB arm and 33

of 52pts (63%) in the BAT arm were non-TI at BL, and BL characteris-

tics were balanced between both patient groups. At wk 24, SVR35 was

observed in 7 of 72 pts (10%) treated with MMB and 1 of 33 pts (3%)

treated with BAT. TSS50 was achieved in 21 of 72 pts (29%) treated with

MMB, but there were no responses in the BAT arm. Additionally, TI-R was

achieved in 25 of 72 pts (35%) treated with MMB compared with only 1

of 33 (3%) treated in the BAT arm on RUX. Many responders with MMB

achieved 2or all 3 endpoints (16 of 36 responders [44%]); there were no

dual or triple responses in the BAT arm.

Conclusions: In RUX/BAT-treated pts with MF who required RBC trans-

fusions, continued treatment with RUX/BAT in most pts resulted in poor

treatment outcomes compared with MMB. Overall, these data support

MMB as a potential alternative treatment option for pts with MF who

require RBC transfusions.

ENCORE. © American Society of Hematology (2023) Reused with permission.

Disclosure Statement: e authors declare no conict of interest.

549

Ecacy of Pirtobrutinib in BTK-Inhibitor Pre-treated Relapsed/

Refractory CLL/SLL: Phase 1/2 BRUIN Study Results by Prior

BCL2-Inhibitor Therapy

Jennifer A. Woyach1; Jennifer R. Brown2; Paolo Ghia3; Lindsey E. Roeker4;

Krish Patel5; Toby A. Eyre6; Talha Munir7; Ewa Lech-Maranda8; Nicole

Lamanna9; Constantine S. Tam10; John Seymour11; Nirav N. Shah12;

Chaitra Ujjani13; Bita Fahkri14; Catherine C. Coombs15; Ian Flinn16;

Manisha R. Patel17; Sunita D. Nasta18; Jonathon B. Cohen19;

Alvaro J. Alencar20; Chan Y. Cheah21; Shuo MA10; Joanna M. Rhoades22;

Deepa Jagadeesh23; Pier Luigi Zinzani24; Anders Osterborg25; Koji Izutsu26;

Donald E. Tsai27; Paolo Abada27; Minna Balbas28; Amy S. Ruppert28;

Jian LI28; Wojciech Jurczak29; William G. Wierda30; Stephan Stilgenbauer31

1The Ohio State University Comprehensive Cancer Center, Columbus, USA

2Dana-Farber Cancer Institute and Harvard Medical School, Boston, USA

3Università Vita-Salute San Raaele and IRCCS Ospedale San Raaele, Milano, Italien

4Memorial Sloan-Kettering Cancer Center, New York, USA

5Swedish Cancer Institute - Seattle, Seattle, USA

6Oxford University Hospitals NHS Foundation Trust, Churchill Cancer Center,

Oxford, United Kingdom

7Department of Haematology, St. James’s University Hospital, Leeds, United

Kingdom

8Institute of Hematology and Transfusion Medicine, Warsaw, Polen

9The Herbert Irving Comprehensive Cancer Center, Columbia University, New York,

USA

10Robert H. Lurie Comprehensive Cancer Center of Northwestern University,

Chicago, USA

11Royal Melbourne Hospital, Peter MacCallum Cancer Centre and University of

Melbourne, Melbourne, Victoria, Australien

12Medical College of Wisconsin, Milwaukee, USA

13Fred Hutchinson Cancer Center, Seattle, USA

14Division of Hematology at Stanford University School of Medicine, Stanford, USA

15University of California, Irvine, USA

16Sarah Cannon Research Institute, Nashville, USA

17Florida Cancer Specialists/Sarah Cannon Research Institute, Nashville, USA

18Abramson Cancer Center, University of Pennsylvania, Philadelphia, USA

19Winship Cancer Institute, Emory University, Atlanta, USA

20Sylvester Comprehensive Cancer Center, Miami, USA

21Linear Clinical Research and Sir Charles Gairdner Hospital, West Australia, Australien

22Rutgers Cancer Institute of New Jersey, New Brunswick, USA

23Cleveland Clinic, Cleveland, USA

24Institute of Hematology “Seràgnoli” University of Bologna, Bologna, Italien

25Karolinska Institute, Stockholm, Schweden

26National Cancer Center Hospital, Chuo City, Japan

27Loxo@Lilly, Indianapolis, USA

28Eli Lilly and Company, Indianapolis, USA

29Maria Sklodowksa-Curie National Research Institute of Oncology, Krakow, Polen

30MD Anderson Cancer Center, Houston, USA

31Universitätsklinikum Ulm, Ulm, Deutschland

Background: Pirtobrutinib, a selective, non-covalent BTKi, has shown e-

cacy and safety in pre-treated CLL/SLL patients (pts) receiving a prior BTKi.

Here, we report CLL/SLL results from BRUIN (NCT03740529) focusing on

pts who received prior BTKi therapy, with or without BCL2i therapy.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 119

Methods: Pts with previously treated B-cell malignancies, including CLL/

SLL, were eligible for pirtobrutinib monotherapy in phase 1/2 BRUIN study.

Endpoints included overall response rate (ORR) including partial response

with lymphocytosis (PR-L), progression-free survival (PFS), and safety.

Results: In total, 282 pts with CLL/SLL who received prior BTKi were

enrolled. Median age was 69 years, 68% were male, and median number

of prior therapies was 4 (range, 1-11). Of the 282 pts, 128 (45%) had also

received prior BCL2i therapy. Pts who received prior BTKi and BCL2i had

more aggressive disease characteristics, more exposure to prior therapies,

and frequently discontinued prior BTKi therapy due to disease progres-

sion (84% vs 71%) compared to BTKi only. e ORR for all pts was 72.0%

(95% CI, 66.4-77.1), including 5 complete responses (CR), 2 nodular par-

tial responses (nPR) and 196 PR. ORR including PR-L was 81.6% (95%

CI, 76.5-85.9), and was consistent among pts who received prior BTKi

and BCL2i (79.7%; 95% CI, 71.7-86.3) or BTKi only (83.1%; 95% CI, 76.2-

88.7). Median PFS was 19.4 months (m) (95% CI, 16.6-22.1) across all

pts, 15.9m (95% CI, 13.6-17.5) in pts who received prior BTKi and BCL2i,

and 23.0m (95% CI, 19.6-28.4) in BTKi only pts. e most common treat-

ment-emergent adverse events (TEAE) were fatigue (36.9%), diarrhea

(28.4%), cough (27.3%), and contusion (26.2%). e most common Grade

≥3 TEAE was neutropenia (28.4%). Grade ≥3 neutropenia was higher

in pts who received prior BCL2i than pts who had not (36.7% v 21.4%).

Seven (2.5%) pts discontinued Pirto due to a TEAE.

Discussion: Pirto demonstrates promising and durable ecacy in

pre-treated CLL/SLL pts with prior BTKi therapy.

Conclusion: Pirto was well-tolerated, regardless of prior BCL2i therapy,

with low-rates of discontinuation due to TEAE.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

567

Pirtobrutinib in Relapsed/Refractory (R/R) Mantle Cell

Lymphoma (MCL) Patients with Prior cBTKi: Updated Safety

and Ecacy including High-Risk Subgroup Analyses from the

Phase 1/2 BRUIN Study

Jonathon B. Cohen1; Nirav N. Shah2; Wojciech Jurczak3; Pier Luigi Zinzani4;

Chan Y. Cheah5; Toby A. Eyre6; Chaitra S. Ujjani7; Youngil Koh8; Won Seog

Kim9; Sunita D. Nasta10; Ian Flinn11; Benoit Tessoulin12; Shuo MA13;

Alvaro J. Alencar14; David J. Lewis15; Jennifer A. Woyach16; Kami J.

Maddocks16; Krish Patel17; Yucai Wang18; Joanna Rhodes19; Constantine S.

Tam20; John F. Seymour21; Hirokazu Nagai22; Julie M. Vose23; Bita Fakhri24;

Marc S. Homann25; Francisco Hernandez-Ilizaliturr26; Andrew D. Zelenetz27;

Anita Kumar27; Talha Munir28; Donald Tsai29; Minna Balbas30; Bin Liu31;

Amy S. Ruppert31; Bastien Nguyen29; Lindsey E. Roeker27;

Michael L. Wang32; Martin Dreyling33

1Winship Cancer Institute, Emory University, Atlanta, USA

2Medical College of Wisconsin, Milwaukee, USA

3Maria Sklodowska-Curie National Research Institute of Oncology, Krakow, Polen

4Institute of Hematology “Seràgnoli” University of Bologna, Bologna, Italien

5Linear Clinical Research and Sir Charles Gairdner Hospital, Western Australia,

Australien

6Oxford University Hospitals NHS Foundation Trust, Churchill Cancer Center,

Churchill Cancer Center, Oxford, United Kingdom

7Fred Hutchinson Cancer Center, Seattle, USA

8Department of Internal Medicine, Seoul National University Hospital, Seoul,

Republik Korea

9Hematology and Oncology at Sungkyunkwan University School of Medicine,

Seoul, Republik Korea

10Abramson Cancer Center, University of Pennsylvania, Philadelphia, USA

11Sarah Cannon Research Institute, Nashville, USA

12Haematology Department, University Hospital, Nantes, Frankreich

13Robert H. Lurie Comprehensive Cancer Center of Northwestern University,

Chicago, USA

14Sylvester Comprehensive Cancer Center, Miami, USA

15University Hospitals Plymouth NHS, Plymouth, United Kingdom

16The Ohio State University Comprehensive Cancer Center, Columbus, USA

17Swedish Cancer Institute - Seattle, Seattle, USA

18Division of Hematology, Mayo Clinic, Rochester, USA

19Rutgers Cancer Institute of New Jersey, New Brunswick, USA

20Alfred Health and Monash University, Melbourne, Victoria, Australien

21Royal Melbourne Hospital, Peter MacCallum Cancer Centre and University of

Melbourne, Melbourne, Australien

22Department of Hematology and Oncology Research, National Hospital

Organization, Nagoya Medical Center, Nagoya, Japan

23University of Nebraska Medical Center, Omaha, USA

24Division of Hematology at Stanford University School of Medicine, Stanford, USA

25The University of Kansas Cancer Center, Kansas City, USA

26Roswell Park Comprehensive Cancer Center, Jacobs School of Medicine and

Biomedical Sciences, University at Bualo, Bualo, USA

27Memorial Sloan-Kettering Cancer Center, New York, USA

28Department of Haematology, St. James‘s University Hospital, Leeds,

UnitedKingdom

29Loxo@Lilly, Indianapolis, USA

31Eli Lilly and Company, Indianapolis, USA

32MD Anderson Cancer Center, Houston, USA

33LMU Klinikum Campus Großhadern, München, Deutschland

Background: Pirtobrutinib is a highly selective, non-covalent (reversible)

Bruton tyrosine kinase inhibitor (BTKi). Here, we report updated results

of pirtobrutinib therapy in all patients (pts) with subset analysis of high-

risk R/R MCL.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts120

Methods: MCL pts received pirtobrutinib monotherapy in the Phase 1/2

BRUIN trial (NCT03740529) Key endpoints included ORR, DOR, PFS,

OS, and safety. A data cut of 05 May 2023 was utilized.

Results: Median age in cBTKi (covalent BTKi) pre-treated pts was 70

years (range, 46-88). 52% had intermediate-risk and 28.3% had high-risk

by sMIPI. Median prior therapy lines was 3 (range, 1-9). Common prior

treatments were anti-CD20 antibody (97%), chemotherapy (90%) and

cBTKi (XX%). 50% had TP53 mutations and 71% had Ki-67 index ≥30%.

ORR for cBTKi pre-treated pts was 49.3% (95% CI, 41.1-57.6), including

15.8% complete responses and 33.6% partial responses. cBTKi naive pts

(n=14) had an ORR of 85.7% (95% CI, 57.2-98.2). ORR among 128 pts

who discontinued a prior cBTKi due to PD and 21 pts who discontinued

for toxicity/other was 43.0%/90.5%, respectively.

Among cBTKi pre-treated pts, median DOR was 21.6 months (m) (95%

CI, 9.2-27.2) at a median follow-up of 24m. e 18/24m DOR rates were

51.9% (95% CI, 37-64.8)/38.9% (95% CI, 22.7-54.8), respectively. e

18/24m DOR rates among cBTKi naïve pts were both 90.0% (95% CI, 47.3-

98.5). Median PFS/OS for cBTKi pre-treated pts was 5.6m (95% CI, 5.3-

9.2)/23.5m (95% CI, 17.1-NE), respectively. In all patients (N=166), the

most frequent treatment-emergent adverse events (TEAEs) were fatigue

(31.9%), diarrhea (22.3%), and dyspnea (17.5%). e most common Grade

≥3 TEAE was neutropenia/neutrophil count decreased (13.3%). Grade ≥3

hemorrhage/hematoma (2.4%) and all-grade atrial brillation (3.6%) were

infrequent. Overall, 8 pts (5%) had TEAEs leading to dose reductions and

5 (3%) had TEAEs leading to pirtobrutinib discontinuation.

Discussion and Conclusion: Pirtobrutinib demonstrates durable ecacy

and favorable safety prole in heavily pre-treated R/R MCL pts with prior

cBTKi therapy and high-risk disease features.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

578

Pirtobrutinib in Heavily Pre-Treated Richter Transformation:

Updated Ecacy and Safety Results with 18-month Median

Survival Follow-up from the Phase 1/2 BRUIN Study

William G. Wierda1; Nirav N. Shah2; Chan Y. Cheah3; David Lewis4;

Marc S. Homan5; Catherine C. Coombs6; Nicole Lamanna7; Shuo MA8;

Deepa Jagadeesh9; Talha Munir10; Yucai Wang11; Toby A. Eyre12;

Joanna Rhodes13; Matthew Mckinney14; Ewa Lech-Maranda15;

Constantine S. Tam16; Wojciech Jurczak17; Koji Izutsu18; Alvaro Alencar19;

Manish R. Patel20; John F. Seymour21; Jennifer Woyach22; Lindsey E.

Roeker23; Philip A. Thompson21; Paolo Abada24; Caleb Ho24; Narasimha

Marella24; Chunxiao Wang25; Amy S. Ruppert26; Binoj Nair24; Hui Liu24;

Donald E. Tsai24; Paolo Ghia27; Othman Al-Sawaf 28

1MD Anderson Cancer Center, Houston, USA

2Medical College of Wisconsin, Brookeld, USA

3Linnear Clinical Research and Sir Charles Gairdner Hospital and University of

Western Australia, Perth, Australien

4University Hospitals Plymouth NHS Trust, Plymouth, United Kingdom

5The University of Kansas Medical Center, Kansas City, USA

6University of California, Irvine, USA

7Herbert Irving Comprehensive Cancer Center, Columbia University, New York,

USA

8Robert H. Lurie Comprehensive Cancer Center of Northwestern University,

Chicago, USA

9Cleveland Clinic, Cleveland, USA

10Department of Haematology, St James’ University Hospital, Leeds,

UnitedKingdom

11Division of Hematology, Mayo Clinic, Rochester, USA

12Oxford University Hospitals NHS Trust, Churchill Cancer Center, Oxford,

UnitedKingdom

13Rutgers Cancer Institute of New Jersey, New Brunswick, USA

14Duke Cancer Institute, Durham, USA

15Institute of Hematology and Blood Transfusion, Warszawa, Polen

16Alfred Health and Monash University, Melbourne, Victoria, Australien

17Maria Sklodowska-Curie National Research Institute of Oncology, Krakow,

Polen

18National Cancer Center Hospital, Tokyo, Japan

19Sylvester Comprehensive Cancer Center, University of Miami, Miller School of

Medicine, Miami, USA

20Florida Cancer Specialists, Sarah Cannon Research Institute, Sarasota, USA

21Peter MacCallum Cancer Center, Royal Melbourne Hospital and University of

Melbourne, Melbourne, Australien

22The Ohio State University Comprehensive Cancer Center, Columbus, USA

23Memorial Sloan-Kettering Cancer Center, New York, USA

24Loxo@Lilly, Indianapolis, USA

25Eli Lilly and Company, Indianapolis, USA

26Eli Lilly and Company, Indianapolis, USA

27Università Vita-Salute San Raaele and IRCCS Ospedale San Raaele, Milano,

Italien

28University Hospital Cologne, Köln, Deutschland

Background: Pirtobrutinib is a highly selective, non-covalent (reversible)

BTKi. Here, we provide updated safety and ecacy of pirtobrutinib in RT

pts from BRUIN (NCT03740529).

Methods: Pts with previously treated histologically conrmed RT were

eligible in the phase 1/2 BRUIN study. Key endpoints included investi-

gator-assessed ORR, DoR, OS, and safety. A data cut of 05 May 2023 was

utilized. Clonal relationship was assessed via IGH rearrangement studies.

Results: Among pts with RT (N=82), median age was 67 (range, 26-95)

and median total number of prior lines of therapy was 4 (range, 0-13).

Pts with prior treatment had median of 2 CLL-directed therapies and 2

RT-directed therapies. Of 29 pts with bone marrow screening, 41.4% had

CLL alone present in BM, 13.8% had DLBCL present and 24.1% had both.

ORR was 50.0% (95% CI, 38.7-61.3) including complete (13.4%) and par-

tial (36.6%) response. For pts who received prior cBTKi therapy, ORR was

45.9% (95% CI 33.1-59.2). Among pts with an RT-directed cBTKi and pts

with prior CLL-directed cBTKi, the ORR was 42.9% (95% CI, 24.5-62.8)

and 43.1% (95% CI, 29.3-57.8), respectively. At median follow-up time of

9.7 months (m), the median DoR for all pts was 7.4m (95% CI, 3.1-19.1)

and the estimated rate at 12m was 45.9% (95% CI, 28.3-61.8). Median

time on treatment for the 41 treatment responders was 8.3m. At median

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 121

survival follow-up (18.3m), median OS for the full RT cohort was 12.5m

(95% CI, 6.9-20.5). At 18m, the OS rate was 44.3% (95% CI, 32.5-55.4).

Frequent treatment-emergent adverse events (TEAEs) were neutro-

penia/decreased neutrophil count (29.3%), fatigue (24.4%) and diar-

rhea, (18.3%). Common Grade ≥3 TEAEs were neutropenia/decreased

neutrophil count (23.2%), thrombocytopenia (11.0%), and anemia

(9.8%). ree pts (3.7%) had TEAEs leading to dose reductions, but no

pt had TEAE leading to discontinuation. Analyses of clonality will be

presented.

Discussion: Follow-up from BRUIN shows encouraging response and OS

in pts with RT.

Conclusion: Pirtobrutinib remains well-tolerated with low rates of dis-

continuation and manageable safety prole.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

712

Presence of the germline variant GFI1-36N promotes genetic

instability in MLL-AF9 leukemic cells and enhances their

sensitivity to CDK4/6 inhibition

Jan Vorwerk1; Kaiyan Sun1; Daria Frank1; Pradeep Kumar Patnana1,2;

Helal Mohammed Mohammed Ahmed1,2; Felix Neumann3,4;

Michael Heuser5; Desiree Kunadt6; Bertram Opalka7; Wolfgang Berdel1;

Georg Lenz1; Ashok Kumar Jayavelu8,9,10,11,12; Nikolas Christian Cornelius

von Bubno2; Cyrus Khandanpour1,2

1Department of Medicine A, University Hospital Münster, Münster, Deutschland

2Department of Hematology and Oncology, University Hospital Schleswig-

Holstein, Lübeck, Deutschland

3Fluorescence Microscopy Facility Münster, Institute of Medical Physics and

Biophysics, University of Münster, Münster, Deutschland

4Rened Laser Systems GmbH, Münster, Deutschland

5Department of Hematology, Hemostasis, Oncology and Stem Cell

Transplantation, Hannover Medical School, Hannover, Deutschland

6Department of Internal Medicine I, University Hospital Dresden, Dresden,

Deutschland

7Department of Hematology and Stem Cell Transplantation, West German

Cancer Center (WTZ), University Hospital Essen, Essen, Deutschland

8Department of Proteomics and Signal Transduction, Max Planck Institute of

Biochemistry, München, Deutschland

9Clinical Cooperation Unit Pediatric Leukemia, German Cancer Research Center

(DKFZ), Heidelberg, Deutschland

10Department of Pediatric Oncology, Hematology, and Immunology, Heidelberg

University, Heidelberg, Deutschland

11Molecular Medicine Partnership Unit, European Molecular Biology Laboratory

(EMBL), Heidelberg, Deutschland

12Hopp Children’s Cancer Center (KiTZ), Heidelberg, Deutschland

Background: e zinc nger protein Growth Factor Independence 1

(GFI1) acts as a key regulator of hematopoiesis. In a single-nucleotide pol-

ymorphism (SNP) of GFI1, GFI1-36N, serine (S) is replaced by asparagine

(N) at position 36. GFI1-36N has a prevalence of 7% in healthy cauca-

sians and 15% in acute myeloid leukemia (AML) patients. Since GFI1 has

recently been shown to be involved in DNA double-strand break repair

(DSBR), we examined whether reduced DSBR in GFI1-36N leukemic cells

promotes leukemogenesis.

Methods: We analyzed DNA damage in human AML samples. To deter-

mine DSBR activity in a murine model of human AML, we knocked in the

human GFI1-36S or GFI1-36N variant gene constructs into the murine

G1 gene locus and induced AML by expressing MLL-AF9.

Results: Both human (p**=0.0080) and murine (p***=0.0003) GFI1-36N

leukemic cells showed increased mutational burden. Upon irradiation,

murine GFI1-36N-MLL-AF9 cells featured 30% more double-strand breaks

(p*=0.0418) and delayed repair. On a molecular level, GFI1-36N exhibited

impaired binding to Ndrg1 resulting in an insucient O6-methylguanine-

DNA methyltransferase (MGMT)-mediated repair. e SNP was associ-

ated with 40% fewer foci of the DSBR key enzyme Rad51 (p**=0.0020),

higher levels of the pro-proliferative CDKs, and inactivation of the tumor

suppressor Rb1,2. As especially CDK4 (p****<0.0001) and CDK6 (p**=0.0042)

protein levels were increased in GFI1-36N leukemic cells, we observed that

these were more susceptible to palbociclib treatment, indicated by 49%

less colony-forming units (p**=0.0063)1,2.

Discussion: We demonstrated that GFI1-36N-MLL-AF9 cells were asso-

ciated with increased CDK levels leading to Rb inactivation. A possible

consequence is a disturbed cell cycle control in GFI1-36N leukemic cells

enhancing their response to CDK4/6 inhibition.

Conclusion: GFI1-36N could act as a marker for a subset of AML patients

that is sensitive to CDK4/6 inhibitors.

References:

1. Vorwerk. HemaSphere. 2022;6(S3):727–8.

2. Vorwerk. Front Oncol. 2022;12:903691.

Disclosure Statement: e authors declare no conict of interest.

748

Expression-linked and R-ISS-Adapted Stratication for rst

line therapy in multiple myeloma patients (ELIAS)

Theo Leitner1; Marion Högner2; Florian Bassermann2; Katja Weisel3;

Jan Krönke4; Axel Nogai4; Stefan Knop5; Leo Rasche6; Pearl van Heteren7;

Evgenii Shumilov8; Raphael Koch9; Inke König10; Kathrin Klinge11;

Kay Horn11; Nikolas Christian Cornelius von Bubno1; Cyrus Khandanpour1

1Klinik für Hämatologie und Onkologie, Universitätsklinikum Schleswig-Holstein,

Campus Lübeck, Lübeck, Deutschland

2Klinik und Poliklinik für Innere Medizin III, Universitätsklinikum rechts der Isar

der TU-München, München, Deutschland

3II. Medizinischen Klinik und Poliklinik, Universitätsklinikum Hamburg-

Eppendorf, Hamburg, Deutschland

4Medizinische Klinik mit Schwerpunkt Hämatologie, Onkologie und

Tumorimmunologie (CBF), Charité - Universitätsmedizin Berlin, Berlin,

Deutschland

5Klinik für Innere Medizin 5, Schwerpunkt Onkologie /Hämatologie, Klinikum

Nürnberg, Nürnberg, Deutschland, 6Medizinische Klinik und Poliklinik II,

Uniklinikum Würzburg, Würzburg, Deutschland

7Hämatologie und Zelltherapie, Helios Klinikum Berlin-Buch, Berlin, Deutschland

8Medizinische Klinik A, Universitätsklinikum Münster, Deutschland, Münster,

Deutschland

9Institut für Biometrie und Klinische Forschung, Medizinischen Fakultät der

Westfälischen Wilhelms-Universität Münster, Universität Münster, Münster,

Deutschland

10Institut für Medizinische Biometrie und Statistik, Universität zu Lübeck,

Lübeck, Deutschland

11Zentrum für Klinische Studien, Universität zu Lübeck, Lübeck, Deutschland

Background: Newly diagnosed transplant-eligible patients with multiple

myeloma (MM) generally undergo several cycles of induction, followed

by high-dose melphalan (HDM) and autologous stem cell transfusion

(ASCT). In MM patients, HDM improves overall and progression-free

survival (OS and PFS). But it remains to be answered, whether also low

risk patients have an additional benet from HDM therapy compared to

less toxic regimen.

Methods: In this multicentre phase II, interventional, controlled, random-

ized, prospective, and open-label study we evaluate whether patients with

a low-risk prole (R-ISS stage I, low tumor burden, absence of adverse

cytogenetic ndings and a low-risk gene expression prole) might be

suciently treated with intensied consolidation without upfront HDM

chemotherapy. e study investigates the impact and the risk-benet ratio

of three cycles of isatuximab, bortezomib, lenalidomide und dexametha-

sone (I-VRD), stem cell apheresis and high-dose melphalan followed by

ASCT and an isatuximab and lenalidomide based maintenance therapy

as the standard of care control treatment group compared to the experi-

mental group treated with 3 cycles of I-VRD, stem cell apheresis and three

subsequent consolidation cycles of I-VRD followed by an isatuximab and

lenalidomide based maintenance therapy. All patients start with an I-VRD

induction treatment and will be randomized aer 3 cycles.

Result: e primary objective is to show non-inferiority of the experi-

mental arm compared to the control arm regarding the rate of patients

with minimal residual disease (MRD) negativity combined with at least

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts122

a complete remission response according to IMWG criteria at week 40

aer start of induction therapy. Furthermore, we aim to detect possible

dierences in MRD negativity at specic points of time and to characterize

both arms with respect to OS and PFS since randomization, PFS during

second-line treatment since relapse, time to next treatment, and overall

response rate.

Disclosure Statement: e authors declare the following: e study is nanced by

Sano.

771

Symptomatic patients with hyperleukocytic FLT3-ITD

wildtype acute myeloid myeloid leukemia do not benet from

leukapheresis

Kiavasch Mohammad Nejad Farid1; Tim Sauer1; Michael Schmitt1,2;

Carsten Müller-Tidow1; Anita Schmitt1

1Universitätsklinikum Heidelberg, Medizinische Klinik V, Heidelberg,

Deutschland

2Konsortium für translationale Krebsforschung, Deutsches

Krebsforschungszentrum, Nationales Centrum für Tumorerkrankungen,

Heidelberg, Deutschland

Background: Leukostasis in hyperleukocytotic acute myeloid leukemia

(AML) is a medical emergency. e optimal treatment strategy and the

potential benet of incorporating emergency leukapheresis (LA) are still

unclear. We aimed to identify subsets of patients who benet from emer-

gency LA and to establish a therapeutic algorithm for AML patients with

hyperleukocytosis.

Methods: In this single-center retrospective cohort study a total of 20

consecutive patients underwent LA because of clinical symptoms. Overall

survival (OS) analysis was conducted using Kaplan-Meier curve method.

Univariate and multivariate analyses were conducted using Fisher’s

exact test and multivariate logistic regression. At the time of diagnosis

all patients received standard diagnostics for AML including FLT3-ITD

mutational analysis.

Result: FLT3-ITD mutated (mut) AML patients receiving LA had a median

OS of 437 days (range 5-2,379 days) with a corresponding 14-day-survival

of 92.3%, while FLT3 wildtype (wt) AML patients displayed a signicantly

lower median OS of only 5 days (range 1-203 days) with a corresponding

7-day-survival of 14.3% (p = 0.0006). One-year-survival in the LA group

was 61.5% of FLT3 mut AML patients, whereas none of the FLT3 wt AML

patients presenting with leukostasis receiving LA survived up to one year

aer initial diagnosis.

Discussion: Among patients with clinical symptoms of leukostasis, the

subset of FLT3-ITD mut AML patients showed a better outcome aer

emergency LA. Based on these observations, we established a therapeutic

algorithm for AML patients with hyperleukocytosis.

Conclusion: Although LA is almost exclusively indicated in symptomatic

leukostasis, our results suggest that knowledge of mutational status could

guide early treatment decisions and that FLT3-ITD mutated AML patients

presenting with hyperleukocytosis and symptomatic leukostasis could

benet from LA with a reduction in early mortality.

Disclosure Statement: e authors declare no conict of interest.

784

Longitudinal Assessment of Transfusion Intensity in Patients

with JAK Inhibitor–Naive or –Experienced Myelobrosis

Treated with Momelotinib in the Phase 3 SIMPLIFY-1 and

MOMENTUM Trials

Ruben Mesa1; Martin Griesshammer2; Andrew Perkins3; Yeow Tee Goh4;

Maria Laura Fox5; Donal Mclornan6; Jeanne Palmer7; Lynda Foltz8;

Alessandro M Vannucchi9; Steen Koschmieder10; Francesco Passamonti11;

Sung Eun Lee12; Jun Kawashima13; Bryan Strouse14; Francisco Gonzalez

Carreras15; Stephen Oh16

1Atrium Health Wake Forest Baptist Comprehensive Cancer Center, Winston-

Salem, NC, USA

2University Clinic for Hematology, Oncology, Haemostaseology and Palliative

Care, Johannes Wesling Medical Center, Minden, Deutschland

3Monash University, Melbourne, Australia

4SingHealth Duke-NUS Blood Cancer Center, Singapore General Hospital,

Singapore, Singapore

5Vall d‘Hebron University Hospital, Barcelona, Spain, Barcelona

6University College London Hospitals NHS Trust, London, UK, London

7Mayo Clinic, Phoenix, AZ, USA

8University of British Columbia, Vancouver, BC, Canada

9University of Florence, Florence, Italy, Florence

10RWTH Aachen University and Center for Integrated Oncology Aachen Bonn

Cologne Düsseldorf (CIO ABCD), Aachen, Germany

11University of Milano Statale, Milano, Italy

12Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, South Korea

13Sierra Oncology, San Mateo, CA, USA

14GSK plc, Philadelphia, PA, USA

15GSK, Stevenage, UK, Stevenage

16Washington University School of Medicine, St Louis, MO, USA

Background: We assessed and characterized the impact of Momelotinib

(MMB) and comparators on transfusion burden in patients (pts) with JAK

inhibitor–naive and –experienced myelobrosis (MF) from the phase 3

SIMPLIFY-1 and MOMENTUM trials.

Methods: is analysis evaluated time-dependent transfusion bur-

den in pts enrolled in the phase 3 SIMPLIFY-1 (NCT01969838) and

MOMENTUM (NCT04173494) trials. SIMPLIFY-1 included pts with

JAK inhibitor–naive MF randomized (1:1) to receive MMB or ruxolitinib

(RUX). In MOMENTUM, pts with symptomatic (Myelobrosis Symptom

Assessment Form Total Symptom Score ≥10), anemic (hemoglobin <10

g/dL), JAK inhibitor–experienced MF were randomized (2:1) to receive

MMB or danazol (DAN). Time-dependent transfusion burden was quan-

tied by number of RBC units administered, in a tabular display of base-

line- and treatment-period intensity.

Results: In SIMPLIFY-1 (JAK inhibitor–naive pts), 150 of 213 evaluable

pts (70%) in the MMB arm and 163 of 216 evaluable pts (76%) in the RUX

arm required zero units of RBC transfusion per 28 days at baseline. Of pts

who required zero units of transfusion at baseline, a higher proportion in

the MMB arm (142 of 150 [95%]) maintained a requirement of zero RBC

transfusions during randomized treatment of 24 wks vs the RUX arm (93

of 163 [57%]).

In MOMENTUM (JAK inhibitor–experienced pts), most pts had some

transfusion requirement at baseline, with 26 of 130 (20%) in the MMB arm

and 11 of 65 (17%) in the DAN arm requiring zero units of RBC transfu-

sion per 28 days. During randomized treatment, a higher proportion of pts

in the MMB arm (46 of 130 [35%]) required zero units of RBC transfusion

vs the DAN arm (11 of 65 [17%]).

Conclusions: ese data demonstrate that MMB was associated with bet-

ter maintenance of RBC transfusion intensity and zero RBC transfusion

status vs RUX in pts with MF who were JAK inhibitor naive and showed

greater reduction in RBC transfusion burden from baseline vs DAN in pts

with MF who were JAK inhibitor experienced. Across both trials, ≥85%

of pts treated with MMB maintained or improved transfusion intensity.

ENCORE to ASH (2023).

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 123

817

The function of the BH3-only protein NOXA for BH3-mimetic-

induced apoptosis in lymphoma cells

Marius Anders1; Nahide Yildirim1; Victoria M. Smith2; Sandrine Jayne2;

Martin J. S. Dyer2; Meike Vogler1

1Institute for Experimental Pediatric Haematology and Oncology, Goethe

University, Frankfurt am Main, Deutschland

2Ernest and Helen Scott Haematological Research Institute, University of

Leicester, Leicester, United Kingdom

Background: Programmed cell death maintains tissue homeostasis and

eliminates potentially harmful cells. Critically involved in the regulation

of apoptosis are the BCL-2 (B-cell lymphoma 2) proteins, comprising

anti-apoptotic as well as pro-apoptotic members. Evasion of apoptosis is a

hallmark of cancer. In lymphoma cells, particularly in diuse large B-cell

lymphoma (DLBCL), apoptosis resistance is frequently driven by an over-

expression of anti-apoptotic BCL-2 proteins like the founding member

BCL-2, MCL-1 or BCL-XL. erefore, a highly promising novel strategy

in cancer treatment is the development of so called BH3-mimetics which

functionally mimic BH3-only proteins and counteract the anti-apoptotic

BCL-2 proteins. e rst FDA-approved clinical BH3-mimetic ABT-199/

Venetoclax selectively targets BCL-2 and is used successfully in the treat-

ment of CLL and AML. However, clinical trials show rather poor ecacy

in DLBCL. Lab-based studies indicate that specic inhibitors of MCL-1

(S63845) and BCL-XL (A1331852) might also be eective in DLBCL, out-

lining alternative treatment strategies. Here we investigated the role of the

BH3-only protein NOXA in apoptosis induced by BH3-mimetics target-

ing BCL-2 or BCL-XL. Of note, NOXA selectively binds to MCL-1, and

hence does not directly interfere with BH3-mimetics targeting BCL-2 or

BCL-XL.

Methods: e role of NOXA was investigated using CRISPR/Cas9 medi-

ated knockout in DLBCL cells that are dependent on BCL-2 or BCL-XL

for survival.

Result: Loss of NOXA signicantly reduced sensitivity to ABT-199 or

A1331852, highlighting its importance for apoptosis induced by BH3-

mimetics targeting BCL-2 or BCL-XL. e additional inhibition of MCL-1

could resensitize the cells.

Discussion: ese results indicate that the role of the NOXA/MCL-1 axis

has been underestimated in the treatment of DLBCL with BH3-mimetics

so far.

Conclusion: e ndings can help to use this kind of therapeutics in a

more targeted way for the therapy of lymphoma patients in the future.

Disclosure Statement: e authors declare no conict of interest.

882

Environmental hazards associated with incidence of Multiple

Myeloma in North Rhine-Westphalia - a population-based

ecological analysis

Christine Eisfeld1,2; Lennart Möller1; Kevin Claaßen1; Madeleine Karpinski1;

Johannes Hüsing1; Hiltraud Kajüter1; Andreas Stang1,3,4

1Landeskrebsregister NRW gGmbH, Bochum, Deutschland

2Universitätsklinikum Münster, Medizinische Klinik A, Münster, Deutschland

3Universitätsklinikum Essen, Institut für Medizinische Informatik, Biometrie und

Epidemiologie (IMIBE), Essen, Deutschland

4Boston University, School of Public Health, Department of Epidemiology,

Boston, USA

Background: Multiple Myeloma (MM) is one of the most common

hematological diseases with a multifactorial genesis. Acknowledging that

advanced age is the main risk factor for the development of MM, the body

of evidence about the role of environmental hazards is growing. Among

others, pesticides and farming as well as ambient pollution from particu-

late matter (PM2.5) have been suggested as potentially causal factors.

Methods: Using data from the Cancer Registry of North Rhine-

Westphalia (NRW), we allocated each patient to one of 396 municipali-

ties according to the place of residence at diagnosis. Data on agricultural

land use were retrieved from the regional authorities, mean ambient PM2.5

background concentrations were provided by the Federal Environment

Agency. Environmental data on municipality level were aggregated to

quintiles. Average directly age-standardized incidence rates (standard:

population of NRW) for MM in 2008-2019 were estimated separately

for the top and for the bottom agricultural land use quintiles and PM2.5

concentration quintiles, respectively, and were compared to derive inci-

dence rate ratios (IR).

Result: In the respective bottom and top quintiles, agricultural land use

was <32% and > 67% of total area and ambient PM2.5 concentrations were

<13.5 µg/m3 and > 16.1 µg/m3. IR for agricultural land use were 1.12 (95%-

CI, 1.03-1.22) for men and 1.12 (1.02-1.22) for women. IR for PM2.5 con-

centration were 1.05 (0.98-1.14) for men and 0.98 (0.90-1.06) for women.

Discussion: MM incidence is slightly elevated in the top agricultural land

use quintile as compared to the bottom quintile. ere is no evidence

about elevated MM incidence in the top PM2.5 concentration quintile as

compared to the bottom quintile.

Conclusion: e observed elevated incidence of MM in areas with dom-

inant agriculture is in alignment with international studies. Population-

based evidence about associations between MM and environment might

be enhanced by geospatial regression analysis controlling for potential

confounders.

Disclosure Statement: e authors declare no conict of interest.

952

Impact of EVI1 on cells proliferation and engraftment

suggests therapeutic potential in malignancies

Robin Berner; Susanne Lux; Julius Gräsel; Michael Milsom

Abteilung Experimentelle Hämatologie, Deutsches Krebsforschungszentrum

(DKFZ), Heidelberg, Deutschland

Background: AML is one of the most aggressive diseases of the hemato-

poietic system and the most frequent acute leukemia in adults. Despite an

improved understanding of the underlying molecular processes, treatment

options have mostly stayed the same for a long time and the already bad

prognosis gets even worse in case of specic genetic abnormalities. Some

of them are leading to aberrant high expression of EVI1 and have been

classied as adverse risk. EVI1 expression is predominantly restricted to

HSCs where it modulates the cell’s self-renewal capacity. In case of overex-

pression, it comes to a massive increase proliferation with a myeloid bias.

Methods: In transplantation studies with mice our lab identied EVI1 as a

target gene that can abrogate the strong engrament defect of HSPCs from

a DNA repair decient FancA-/- mouse model. To further investigate the

role of EVI1, a shRNA-mediated knockdown of EVI1 in human AML-cell

lines was performed.

Result: Retroviral-mediated overexpression of Evi1 in HSPCs from a

mouse model with a defective Fanconi pathway led to robust and sus-

tained multi-lineage engrament in case of transplantation, albeit show-

ing a pronounced myeloid bias and causing AML aer a while, which

was also the case when using WT HSPCs. We explored if leukemia cells

with intact FA pathways and high EVI1 expression rely on it for survival

and therapy resistance. When performing the EVI1 knockdown, we saw

that the proliferation of OCI-M1 cells was decreased compared to WT

cells and poorer survival rates were detected when facing some thera-

peutic agents.

Discussion: Our study provides evidence supporting the signicance of

EVI1 in the context of leukemia, particularly within the framework of FA

and further suggests that EVI1 may also modulate the DDR in non-FA

patients which may contribute to the poor response of EVI1 overexpress-

ing AMLs to chemotherapy.

Conclusion: Our study underscores the urgency of pursuing innovative

treatment strategies to oer renewed hope and improved outcomes for

those who are currently facing poor prognosis and limited therapeutic

options.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts124

Imaging

228

Accuracy of intraoperative specimenPET/CT for PSMA-positive

cancer foci in radical prostatectomy

Theresa Kahl1; Alexandros Moraitis2; Pedro Fragoso Costa2;

Wolfgang Fendler2; Francesco Barbato2; Henning Reis3; Jens Köllermann3;

Lukas Püllen1; Claudia Kesch1; Ulrich Krat1; Jens Kleesiek4;

Boris Hadaschik1; Ken Herrmann2; Christopher Darr1

1Universitätsklinikum Essen, Department of Urology, Essen, Deutschland

2Universitätsklinikum Essen, Department of Nuclear Medicine, Essen,

Deutschland

3Universitätsklinikum Frankfurt, Institute of Pathology, Frankfurt am Main,

Deutschland

4Universitätsklinikum Essen, Institute of Articial Intelligence in Medicine, Essen,

Deutschland

Background: In high-risk prostate cancer (PC) avoidance of unfavor-

able positive surgical margins (PSM) during radical prostatectomy (RP)

is associated with improved cancer control. We evaluate the accuracy of

a novel intraoperative specimenPET/CT (sPET/CT) scanner (AURA10;

XEOS Medical, Ghent, Belgium) for real-time whole gland assessment.

Methods: Six high-risk PC patients undergoing RP with preoperative

18F-PSMA-PET/CT were included in this analysis, median activity of

329.5 MBq 18F-PSMA. Aer removal of the prostate gland, ex vivo imag-

ing was performed with a median time of 282 min p.i. Lesion segmenta-

tion was done using an iterative thresholding method and 30%-threshold

of SUVmax (iso30). Comparison with histopathology included tumor vol-

ume and PSM.

Result: e index lesion was always correctly localized (n=6), signi-

cant lesions in 14 out of 15 (93%). Pearson regression was signicant for

iterative thresholding as well as iso30 with a coecient of 0.8 (p=0.028)

regarding the index lesion. For all signicant lesions, Pearson-coecient

demonstrated a good correlation with a coecient of 0.8 (p<0.001).

In three patients, 6 PSMs were detected in histopathology. 5 of 6 PSM

showed a corresponding tracer signal with both evaluation methods.

However, one lesion was not visualized, which was also not visible in

conventional PET/CT. One patient showed positive lymph nodes in the

mesorectum, which could also be detected intraoperatively.

Discussion: Intraoperative sPET/CT shows promising agreement with

histopathology. However, PSMA-negative foci cannot be assessed. Image-

guided resection of locally advanced tumors or atypical lymph node

metastases demonstrates potential for prospective trials.

Conclusion Intraoperative PET/CT correlates well with histopathology

using either an iterative assessment or 30% threshold. Image-guidance

may help balancing oncological and functional outcomes in the future.

Disclosure Statement: e authors declare no conict of interest.

Lung Cancer

Five-year survival in patients with ES-SCLC treated with

atezolizumab in IMpower133: IMbrella A extension

studyresults

Wolfgang Schütte1; Stephen Liu2; Rafal Dziadziuszko3;

Shunichi Sugawara4; Steven Kao5; Maximilian Hochmair6;

Florian Huemer6; Gilberto Castro7; Libor Havel8; Reyes Bernabe Caro9;

Gyorgy Losonczy10; Jong-Seok Lee11; Dariusz Kowalski12; Zoran Andric13;

Raaele Califano14; Andrea Veatch15; Gregory Gerstner16; Marta Batus17;

Stefanie Morris18; Monika Kaul19; Madeena Siddiqui19; Huafei LI20;

Wei Zhang19; Barzin Nabet19; Martin Reck21

1Martha-Maria Hospital, Halle-Dölau, Germany

2Lombardi Comprehensive Cancer Center, Georgetown University, Washington,

DC, USA

3Medical University of Gdańsk, Gdańsk, Poland

4Sendai Kousei Hospital, Sendai, Japan

5Chris O‘Brien Lifehouse, Camperdown, Australia

6Karl Landsteiner Institute of Lung Research and Pulmonary Oncology,

Vienna North Hospital Klinik Floridsdorf, Vienna, Austria

7Ludwig Boltzmann Institute for Lung Health, Klinik Penzing, Vienna, Austria

8Instituto de Cancer do Estado de São Paulo, Hospital das Clínicasda FMUSP,

São Paulo, Brazil

9 Thomayer Hospital, Prague, Czech Republic

10Hospital Universitario Virgen del Rocío, Seville, Spain

11Semmelweis University, Budapest, Hungary

12Seoul National University Bundang Hospital, Seongnam, South Korea

13Maria Skłodowska-Curie National Research Institute of Oncology, Warsaw,

Poland

14Clinical Hospital Centre Bezanijska Kosa, Belgrade, Serbia

15The Christie NHS Foundation Trust and Division of Cancer Sciences,

The University of Manchester, Manchester, UK

16Northwest Medical Specialties, Puyallup, WA, USA

17Illinois Cancer Care, Peoria, IL, USA

18Rush University Medical Center, Chicago, IL, USA

19F. Homann-La Roche Ltd, Basel, Switzerland

20Genentech Inc, South San Francisco, CA, USA

21Roche, Product Development China, Shanghai, China

22Lung Clinic Grosshansdorf, Airway Research Center North, German Center of

Lung Research, Grosshansdorf, Germany

Background: In the Phase III IMpower133 trial (NCT02763579), rst-line

treatment with atezolizumab + carboplatin/etoposide (A+CE) improved

OS and PFS vs placebo + carboplatin/etoposide (P+CE) in patients with

ES-SCLC. At the time of IMpower133 study closure, patients treated with

A+CE were eligible to enrol in the Phase IV, single-arm IMbrella A exten-

sion and long-term observational study (NCT03148418). Given the interest

in long-term OS data for immunotherapy in ES-SCLC, we report patient

outcomes from IMbrella A as an extension of the IMpower133 results.

Methods: Patients enrolled in IMpower133 were eligible for roll-over to

the open-label, non-randomised, multicentre IMbrella A extension study

if they continued to receive atezolizumab at the time of IMpower133 clo-

sure and did not have local access to the study treatment or if they dis-

continued atezolizumab in IMpower133 and were in survival follow-up.

Patients in the P+CE arm were not eligible for enrolment. Survival, treat-

ment status and safety were assessed in IMbrella A.

Result: Median follow-up was 59.4 months in the A+CE arm (IMpower133

and IMbrella A; clinical cuto date [CCOD]: 16 Mar 2023) vs 26.4 months

in the P+CE arm (IMpower133 only; CCOD: 24 Sep 2022). 18 patients

from the A+CE arm of IMpower133 were enrolled in IMbrella A. e

5-year OS rate in the A+CE arm was 12% (IMpower133 and IMbrella A).

Of the 11 patients still alive at the data cuto date, the median age at base-

line was 59 years, 4 patients had an ECOG PS of 1, 2 patients had baseline

brain metastases and none had baseline liver metastases.

Conclusion: is long-term follow-up analysis of IMpower133 patients

enrolled in the IMbrella A extension study provides the rst report of

5-year survival outcomes for patients who received rst-line cancer immu-

notherapy for ES-SCLC and demonstrates that durable survival benet up

to 5 years is possible with A+CE.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 125

Indication of source: WCLC 2023, OA01.04., S.V. Liu et al.

Disclosure Statement: e authors declare the following: Schütte: Research grants,

investigator fees, honoraria, speakers fees from Lilly, Merck, AstraZeneca, Roche,

Boehringer Ingelheim.

Pulmonary brosis as risk of lung cancer with occupational

exposure to asbestos, silica and other hazards - systematic

review with meta-analysis

Julia Krabbe; Katja Steens; Sarah Drießen; Thomas Kraus

Institut für Arbeits-, Sozial- und Umweltmedizin, Uniklinik RWTH Aachen,

Aachen, Deutschland

Background: e same molecular pathways important in pulmonary

brosis are involved in lung cancer pathogenesis. is systematic review

investigates whether pulmonary brosis due to occupational exposure is a

risk factor for lung cancer in individuals exposed to occupational airborne

hazards.

Methods: We conducted a comprehensive search in Pubmed, EMBASE,

Web of Science and Cochrane with over a hundred search terms according

to PRSIMA guidelines. Aer screening and extraction, quality of evidence

and eligibility criteria for meta-analysis were assessed. Meta-analysis was

performed using a random-eects model.

Result: 54 studies were included in the systematic review. Meta-analysis

of sub-groups identied silicosis as risk factor for lung cancer when inves-

tigating odds ratio (OR) in autopsy studies (OR 1.47; 95%-CI 1.13-1.90)

and for lung cancer mortality in silicosis patients (OR 3.21; 95%-CI 2.67-

3.87). Studies with adjustment for at least smoking identied a signicant

increase in lung cancer risk (OR 1.58; 95%-CI 1.34-1.87). Qualitative anal-

ysis identied asbestosis as risk factor for lung cancer that could be inde-

pendent of smoking or cumulative exposure. For mixed dusts, coal dusts

and other exposures only insucient or no literature could be included.

Discussion: e ndings of this review are in accordance with previous

studies. A few studies indicate asbestosis as independent risk factor for

asbestos-related lung cancer, however, research with reliable adjustment

for smoking and cumulative exposure is scarce. For silica dust, the lack of

appropriate studies limits the conclusions for the independent association

between silicosis and lung cancer.

Conclusion: is systematic review conrms previous ndings with

asbestosis and silicosis indicating a higher risk of lung cancer in exposed

individuals with brosis? compared to exposed workers without brosis.

Individuals with exposure to asbestos and/or silica should be monitored

for lung cancer especially when asbestosis or silicosis is present.

Disclosure Statement: e authors declare the following: TK and JK give talks on

this topic at workshops, seminars, and conferences for which has been paid for

by the organizers including travel and accommodation. JK, SD and TK have done

research in the past funded by German institutions for statutory accident insurance

and prevention with unrestricted grants to the University hospital RWTH Aachen.

TK is chairman of the Medical Expert Advisory Board on Occupa-tional Diseases

of the German Federal Ministry of Labor and Social Aairs.

Asbestos Surveillance Program Aachen (ASPA): Cancer

Mortality among Asbestos Exposed Power Industry Workers

Nelly Otte; Thomas Kraus; Julia Krabbe

Institut für Arbeits-, Sozial- und Umweltmedizin, RWTH Aachen, Uniklinik,

Aachen, Deutschland

Background: e latency period between initial asbestos exposure

and asbestos-related disease can span several decades. e Asbestos

Surveillance Program Aachen (ASPA) aims to detect early asbestos-related

diseases in a cohort of 8,565 power industry workers with a history of

occupational asbestos exposure.

Methods: A mortality follow-up was conducted. Standardized mortal-

ity ratios (SMR) with 95% condence intervals (CI) were calculated for

asbestos-related cancers and stratied by exposure duration, cumulative

dose and smoking behavior. e eect of age at rst exposure, cumulative

exposure and smoking behavior on latency period was examined using

multiple linear regression analysis.

Results: e mortality risk of malignant mesothelioma (MM) increased

with cumulative asbestos exposure but not with exposure duration; the

highest mortality rate (SMR: 21.66; 95% CI 13.58-34.84) was observed in

participants who performed activities with extremely high exposure in a

short period of time. Lung cancer (LC) mortality was not increased (SMR:

0.98; 95% CI 0.80-1.16). Median latency period was 46 (15-63) years for

MM and 44 (15-70) years for LC. Latency was not inuenced by cumula-

tive exposure or smoking habits. Age at rst exposure showed a negative

linear association with latency.

Discussion: Cumulative dose is more appropriate than exposure dura-

tion for estimating the risk of MM. To estimate the risk of MM, activ-

ities with extremely high exposure should be surveyed. e critical age

at death from asbestos-related cancer is between the sixth and eighth

decades of life.

Conclusion: To determine the individual risk of developing MM, cumu-

lative doses as well as data on particularly high exposures should be

collected.

Disclosure Statement: e authors declare no conict of interest.

274

Value of TTF-1 status, PD-L1 TPS and Kras mutation as

prognostic factors in stage IV adenocarcinoma of the lung

treated with carboplatin, pemetrexed and pembrolizumab

according to the KN 189 regimen

Ricarda-Chiara Richter; Dieter Wuerein; Fabian Reich; Joachim Ficker;

Wolfgang Brückl

Pneumologie, Allergologie, Schlafmedizin im Klinikum Nürnberg, Campus Nord,

Nürnberg, Deutschland

Background: e combination of carboplatin, pemetrexed and pembroli-

zumab is currently the preferred standard therapy for patients with met-

astatic non-small cell lung cancer (NSCLC). In addition to PD-L1 tumor

proportion score (TPS), TTF-1 and Kras mutational status are also dis-

cussed as prognostic factors. To date, no routine clinical data have exam-

ined these factors in a homogeneously treated cohort.

Methods: In this retrospective study we analysed data from 110 patients

treated with combination regimen Keynote 189 between 11/18 and 7/22 in

Nuremberg, who had received at least one dose of combination therapy.

Results: Patients with TTF-1- (21.9%) had mPFS and mOS of 3.6 and 11.8

months, respectively, while patients with TTF-1+ had mPFS and mOS of

10.7 and 21.6 months (p=0.253 and 0.251). In contrast, PD-L1 TPS >1%

was associated with signicantly improved mOS of 27 months compared

to TPS of 0% at 12.7 months (p=0.018). Kras mutation including Kras

G12C was not associated with prognosis. e combination of TTF1 status

and PD-L1 separated three distinct prognostic groups with mOS of 45.1,

12.9, and 10.8 months for TTF1/PD-L1+, TTF1 or PD-L1-, and TTF1/

PD-L1-, respectively (p=0.039). In multivariate analysis, only PD-L1 sta-

tus remained an independent prognostic factor for OS.

Discussion: e survival data of our cohort compare very well with

the data of the CTx+IO arm from the KN 189 trial. It is discussed that

TTF-1- is associated with a worse prognosis with pemetrexed-containing

therapies. While we demonstrated a trend toward TTF-1 negativity, the

combination of TTF-1/PD-L1 was associated with even worse survival. At

least these patients should not be treated with this combination. To date, it

is not clear whether other treatment regimens (e.g., 9LA or Poseidon) are

associated with improved survival in these subgroups.

Conclusion: PD-L1 remains the only independent prognostic marker in

the treatment of metastatic NSCLC. While Kras showed no prognostic

value, TTF-1- in patients combined with negative PD-L1-TPS was associ-

ated with a very poor prognosis in terms of overall survival.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts126

342

An observational study to assess the eectiveness and safety

of cemiplimab in patients (pts) with advanced non-small cell

lung cancer (NSCLC) in routine clinical practice within Europe

(CEMI-LUNG)

Christian Geßner1; Frank Griesinger2; Riyaz Shah3; Toby Talbot4;

Satish Venkateshan5; Ashok Krishna6; Alex Seluzhytsky6; David Marsden7

1Department of Pulmonary and Bronchial Medicine, Pulmonary Oce/Medical

Spe, Leipzig, Deutschland

2Department of Hematology and Oncology; Pius Hospital Oldenburg,

University Medicine, Oldenburg, Deutschland

3Department of Medical Oncology, Kent Oncology Centre, Kent,

United Kingdom

4Department of Clinical Oncology, Royal Cornwall Hospital, Cornwall,

United Kingdom

5Department of Medical Aairs, Oncology, Regeneron Pharmaceuticals, Inc.,

Tarrytown, USA

6Department of Medical Aairs, Sano, Cambridge, USA

7Department of Medical Aairs, Sano, Reading, United Kingdom

Background: Blockade of the programed cell death 1 (PD-1) pathway is

the mainstay for the rst-line (1L) treatment of pts with advanced NSCLC

without targetable oncogenic alterations. Cemiplimab, a PD-1 inhibitor,

has improved overall survival (OS) and progression free survival (PFS)

vs chemotherapy in 1L treatment of pts with advanced NSCLC with pro-

gramed cell death-ligand 1 (PD-L1) expression ≥50% and without driver

aberrations. Cemiplimab was licensed as 1L monotherapy in this pt popu-

lation by the FDA (Feb 2021) and EMA (May 2021) based on results from

EMPOWER-Lung 1 (NCT03088540). Currently, there are no prospective

data on the eectiveness and safety of cemiplimab in advanced NSCLC in

routine clinical practice. Such data could provide additional evidence to

guide treatment and optimal use as per the licensed indication, including

pts not typically included in or excluded from clinical trials. CEMI-LUNG

(NCT05363319) is a pragmatic, prospective, noninterventional, observa-

tional cohort study that aims to address these data gaps.

Methods: Pts with advanced NSCLC who are initiating a licensed cemi-

plimab-based regimen as part of their routine clinical practice are eligible.

Study visits will follow the standard-of-care schedule and data will be col-

lected every 3 months on treatment, and every 6 months for 36 months

following treatment discontinuation (maximum study duration, 72

months) until death, loss to follow-up, study withdrawal, or end of study

period, whichever occurs rst.

e study plans to enroll ~300 pts across 30 European sites. Decisions

regarding treatment will be made by the treating physician in accordance

with local clinical practice.

e primary objective is to assess OS. Secondary objectives are to describe

objective response rate, time to response, time to rst subsequent anti-NS-

CLC treatment, duration of response, PFS, and the incidence and severity

of adverse events. ree interim analyses are planned in addition to the

nal analysis. is study is open for enrollment.

Result: Not applicable.

Discussion: Not applicable.

Conclusion: Not applicable.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

345

ctDNA dynamics and neoadjuvant treatment responses in

patients with resectable NSCLC from the phase 3 AEGEAN trial

Christian Schumann1; John V. Heymach2; David Harpole3;

Testuya Mitsudomi4; Janis M. Taube5; Gabriella Galy6;

Maximilian Hochmair7; Thomas Winder8; Ruslan Zukov9;

Gabriel Garbaos10; Shugeng Gao11; Hiroaki Kuroda12; Jian You13;

Kang-Yun Lee14; Lorenzo Antonuzzo15; Mike Aperghis16; Gary J. Doherty16;

Helen Mann16; Tamer M. Fouad17; Martin Reck18; Silvan Becker19

1Pneumology, Thoracic Oncology, Sleep and Respiratory Critical Care Medicine,

Clinics Allgäu, Kempten and Immenstadt, Germany

2Department of Thoracic/Head and Neck Medical Oncology, The University of

Texas, M.D. Anderson Cancer Center, Houston, Texas, USA

3Department of Surgery, Duke University Medical Center, Durham, North

Carolina, USA

4Division of Thoracic Surgery, Department of Surgery, Kindai University Faculty

of Medicine, Osaka-Sayama, Japan

5Bloomberg–Kimmel Institute for Cancer Immunotherapy, Johns Hopkins

Kimmel Cancer Center, Baltimore, Maryland, USA

6Pest County Pulmonology Hospital, Törökbálint, Hungary

7Department of Respiratory and Critical Care Medicine, Karl Landsteiner

Institute of Lung Research and Pulmonary Oncology, Klinik Floridsdorf, Vienna,

Austria

8Department of Hematology, Oncology, Gastroenterology and Infectiology,

Landeskrankenhaus Feldkirch, Feldkirch, Austria

9Krasnoyarsk State Medical University, Krasnoyarsk, Russia

10Fundación Estudios Clínicos, Santa Fe, Argentina

11Thoracic Surgery Department, National Cancer Center/National Clinical

Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical

Sciences and Peking Union Medical College, Beijing, China

12Department of Thoracic Surgery, Aichi Cancer Center Hospital, Aichi, Japan

13Department of Lung Cancer, Tianjin Medical University Cancer Institute and

Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research

Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin,

China

14Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical

University, New Taipei City, Taiwan

15Clinical Oncology Unit, Careggi University Hospital, Department of

Experimental and Clinical Medicine, University of Florence, Florence, Italy

16AstraZeneca, Cambridge, United Kingdom

17AstraZeneca, New York, USA

18Lung Clinic Grosshansdorf, Airway Research Center North, German Center for

Lung Research, Grosshansdorf, Germany

19Department of Oncology, Agaplesion Markus Krankenhaus Frankfurt,

Frankfurt, Germany

Background: Among patients (Pts) with resectable (R) NSCLC in the

AEGEAN trial, perioperative durvalumab (D) + neoadjuvant chemother-

apy (CT) signicantly improved pathological complete response (pCR)

and event-free survival (EFS), with manageable safety, vs. neoadjuvant

CT alone. Here we report exploratory analyses of potential associations

between ctDNA and pCR or major pathological response (MPR) during

the neoadjuvant treatment (Tx) phase in AEGEAN.

Methods: AEGEAN is a double-blind, placebo (PBO)-controlled ran-

domised study (NCT03800134). Adults with Tx-naïve R-NSCLC (stage

II–IIIB[N2]; AJCC 8th ed) and ECOG PS 0/1 were randomized (1:1) to

receive neoadjuvant platinum-based CT + either D 1500 mg or PBO IV

(every 3 weeks [Q3W], 4 cycles) prior to surgery (Sx), followed by D 1500

mg or PBO IV (Q4W, 12 cycles), respectively, aer Sx. Pts were stratied

by disease stage (II vs III) and PD-L1 tumour cell expression (<1% vs ≥1%;

Ventana SP263). Following a protocol amendment, conrmation of EGFR/

ALK status was required prior to randomization. Pts with documented

EGFR/ALK aberrations were excluded from the modied ITT population

for ecacy analyses. e primary endpoints were pCR, evaluated centrally

(per IASLC), and EFS (using RECIST v1.1), evaluated by BICR. Plasma

samples were collected at protocol-specied timepoints, including prior

to each cycle of neoadjuvant Tx. Analysis of ctDNA was performed using

patient-specic tumour-informed assays, following identication of muta-

tions by whole-exome sequencing of diagnostic tissue.

Expected Results: To date, ctDNA analysis has been performed for 198

Pts in the population included in the interim analysis of pCR. e reported

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 127

results will include baseline characteristics of analysed Pts; ctDNA lev-

els and dynamics during neoadjuvant Tx; and potential associations of

ctDNA variables, including ctDNA clearance, with baseline characteris-

tics, pCR or MPR.

Expected Conclusions: ese exploratory analyses are expected to shed

light on the predictive utility of ctDNA in Pts treated with neoadjuvant

D + CT.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

360

TROPION-Lung05: Datopotamab deruxtecan (Dato-DXd) in

previously treated non-small cell lung cancer (NSCLC) with

actionable genomic alterations (AGAs)

Akin Atmaca1; Luis Paz-Ares2; Myung-Ju Ahn3; Aaron Lisberg4; Satoru

Kitazono5; Byoung Chul Cho6; George Blumenschein Jr7; Elaine Shum8;

Elvire Pons Tostivint9; Yasushi Goto10; Kiyotaka Yoh11; Rebecca Heist12;

Paul Baas13; David Planchard14; Maurice Pérol15; Enriqueta Felip16;

Wu-Chou Su17; Hong Zebger-Gong18; Lan Lan19; Chelsea Liu19;

Jacob Sands20; Niels Reinmuth21

1Krankenhaus Nordwest, Frankfurt am Main, Deutschland

2Hospital Universitario 12 de Octubre, Madrid, Spanien

3Samsung Medical Center, Seoul, Republik Korea

4David Geen School of Medicine at UCLA, Los Angeles, USA

5The Cancer Institute Hospital of JFCR, Tokyo, Japan

6Severance Hospital, Seou, Seoul, Republik Korea

7University of Texas MD Anderson Cancer Center, Houston, USA

8NYU Perlmutter Cancer Center, New York, USA

9University Hospital of Nantes, Nantes, Frankreich

10National Cancer Center Hospital, Tokyo, Japan

11National Cancer Center Hospital East, Kashiwa, Japan

12Massachusetts General Hosp. Cancer Ctr., Boston, USA

13The Netherlands Cancer Institute, Amsterdam, Niederlande

14Gustave Roussy, Department of Medical Oncology, Villejuif, Frankreich

15Centre Léon Bérard, Lyon, Frankreich

16Vall d’Hebron University Hospital and Vall d’Hebron Institute of Oncology,

Barcelona, Spanien

17National Cheng Kung University Hospital, Tainan, Taiwan

18Daiichi Sankyo Europe GmbH, Munich, Deutschland

19Daiichi Sankyo, Inc, Basking Ridge, USA

20Dana-Farber Cancer Institute, Boston, USA

21Asklepios Klinik Gauting GmbH, Gauting, Deutschland

Background: Once targeted therapies and platinum-based chemotherapy

(PBC) become ineective in patients (pts) with advanced/metastatic (a/m)

NSCLC with AGAs, few treatments with limited benet are available. Dato-

DXd is an antibody-drug conjugate composed of a TROP2 directed mono-

clonal antibody covalently linked to a highly potent cytotoxic payload via

a stable, tumor-selective, tetrapeptide-based cleavable linker. We report

primary results from the global, open-label, phase 2 TROPION-Lung05

trial (NCT04484142) evaluating Dato-DXd in pts with a/m NSCLC with

AGAs progressing on or aer ≥1 AGA-specic therapy and PBC.

Methods: Dato-DXd 6 mg/kg was given every 21 days to pts with a/m

NSCLC, ECOG status 0 or 1, and ≥1 documented AGA in EGFR, ALK,

ROS1, NTRK, BRAF, MET exon 14 skipping, or RET. e primary end-

point was conrmed objective response rate (cORR) by blinded indepen-

dent central review (BICR). Secondary endpoints included duration of

response (DOR) and disease control rate (DCR) by BICR, and safety.

Result: A total of 137 pts received ≥1 dose and had a median age of 61.0

y; 71.5% had ≥3 prior lines of therapy for a/m NSCLC; 56.9% had EGFR

mutations. As of 14 Dec 2022, 85.4% discontinued therapy, 63.5% had dis-

ease progression, and 49.6% died. Median pt duration on study was 15.2

months (mo); cORR was 35.8%, DCR, 78.8%, and median DOR, 7.0 mo;

similar response was seen in pts with EGFR mutations. e most common

grade ≥3 TEAEs were stomatitis (9.5%), anemia (5.8%), and increased

amylase (5.8%).

Conclusion: Dato-DXd showed encouraging antitumor activity, with a

clinically meaningful and durable response, in heavily pretreated pts with

NSCLC with AGAs. e safety prole was manageable and consistent with

prior safety observed with Dato-DXd. ese data support inclusion of pts

with AGAs in the TROPION-Lung01 study (NCT04656652).

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

393

Increase of stage IV NSCLC diagnoses during the COVID-19

pandemic, a real-world data study of the Network Oncology

registry

Anja Thronicke1; Christian Grah2; Hannah Wüstefeld2; Patricia Grabowski3;

Juliane Roos3; Gerrit Grieb4; Friedemann Schad1,3

1Research Institut Havelhöhe Berlin at Gemeinschaftskrankenhaus Havelhöhe,

Berlin, Deutschland

2Hospital Gemeinschaftskrankenhaus Havelhöhe, Lung Cancer Center, Berlin,

Deutschland

3Hospital Gemeinschaftskrankenhaus Havelhöhe, Interdisciplinary Oncology

and Palliative Care, Berlin, Deutschland

4Hospital Gemeinschaftskrankenhaus Havelhöhe, Department of Plastic Surgery

and Hand Surgery, Berlin, Deutschland

Background: Lung cancer care has been signicantly altered during the

COVID-19 pandemic worldwide. Increasing data indicate shis towards

the diagnoses of advanced tumors during the pandemic years. e aim of

this study was to evaluate tumor stage shis of lung cancer, especially non-

small cell lung cancer (NSCLC) patients, during the pandemic compared

to the pre-pandemic years.

Methods: Demographic, tumor- and treatment-related data from newly

diagnosed lung cancer patients from an accredited German cancer center

were retrieved from the Network Oncology registry and were statistically

descriptively analyzed. e study has been approved by the ethics commit-

tee of the Medical Association Berlin (Eth-27/10).

Result: In total 1118 lung cancer patients were included in the regis-

try study. When looking at NSCLC, signicant tumor stage shis were

observed during 2021 and 2022: while the proportion of UICC stage IV

NSCLC increased by 10.7% (p=0.03) during the rst pandemic year, the

proportion of UICC stage II NSCLC decreased by 8.2% (p=0.01) in the

following year compared to the pre-pandemic years. No signicant shis

were observed for SCLC patients. Finally yet importantly, a 12% decline

of lung cancer diagnoses in 2021 and a 17.2% decline in 2022 was docu-

mented compared to the pre-pandemic years.

Discussion: COVID-19-related diagnostic and treatment delays and

patient’s reluctance have led to clinically meaningful shis towards higher

tumor stages as well as decreases of lung cancer diagnoses in a certied

German lung cancer center.

Conclusion: A signicant increase of stage IV and decrease of stage II of

NSCLC diagnoses during the COVID-19 pandemic were observed. In the

near future, cancer care, patient’s health-related quality of life and the lung

cancer mortality due to tumor stage shis will need to be evaluated.

Disclosure Statement: e authors declare the following: FS reports grants from

AstraZeneca GmbH, Abnoba GmbH, Iscador AG, and Helixor Heilmittel GmbH

outside the submitted work. e other authors declare no conict of interest. CG

reports grants or honoraria from AstraZeneca GmbH, Weleda AG and Chie-

si GmbH outside the submitted work. HW reports grants or hono-raria from

AstraZeneca outside the submitted work. e other authors declare no conict of

interest.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts128

501

The feasibility of acute endurance training in lung cancer

patients and its eects on exercise enjoyment

Jenny Hoart1; Lutz Vogt1; Frieder Krause2; Katharina Graf 2; Elke Jäger2;

Nils Scharath2

1Goethe-Universität Frankfurt am Main, Frankfurt am Main, Deutschland

2Krankenhaus Nordwest, Frankfurt am Main, Deutschland

Background: Substantial evidence underlines the benets of targeted

exercise on treatment-related side eects in cancer patients and sub-

populations with high symptom burdens, e.g., persons with lung cancer.

However, specic exercise modes such as the time-saving high intensity

interval training (HIIT) are less well studied. is study investigates the

feasibility and enjoyment of HIIT in lung cancer patients using spiroer-

gometry and questionnaires.

Methods: A standardized controlled-randomized two-arm design with

lung cancer patients during or aer cancer treatment was conducted.

Aer a maximal, incremental spiroergometry at baseline, the intervention

group participated in one HIIT for 35 minutes, while the control group

engaged in respiratory training (CG). Both groups completed question-

naires regarding quality of life, physical activity and enjoyment.

Result: Out of 16 participants (f = 9, 59.8 ± 6.1y), the dropout rate was 0%.

No adverse events were observed. Both groups showed high positive and

low negative ratings in the enjoyment questionnaire aer baseline testing

(35.7± 3,6; 9.3 ± 2.7) and aer both intervention (HIIT: 37.1 ± 4.3, 9.1±

2.6; p > .05, CG: 38 ± 3.8; 9.3 ± 4; p > .05), indicating a high level of enjoy-

ment. Feasibility of HIIT was reected in values of maximum heart rate

(143.1 ± 11.9) and subjective perception of eort (13.2 ± 0.5).

Discussion: e HIIT was feasible and safe for the lung cancer patients

in our study. Our results show high levels of exercise enjoyment without

signicant dierences between both interventions but indicate a trend for

increased enjoyment aer both interventions compared to the maximal

exercise test.

Conclusion: HIIT seems to be feasible and safe in lung cancer patients’

post-therapy and shows comparable enjoyment ratings as respiratory

training despite the high intensity.

1 Heredia-Ciuró, A., Fernández-Sánchez, et al. (2022). High-intensity interval

training eects in cardiorespiratory tness of lung cancer survivors: a

systematic review and meta-analysis.Supportive care in cancer: MASCC,30(4),

3017–3027.

Disclosure Statement: e authors declare no conict of interest.

511

Five-year Survival Outcome of patients with synchronous

oligometastatic or locally advanced Non-small cell lung cancer

after denitive primary treatment: Results from the West

German Cancer Center, a prospective registry trial

Maja Guberina1,2,12; Christoph Pöttgen2,12; Nika Guberina2,12; Marcel

Wiesweg3,12; Martin Metzenmacher3,12; Cedric Richlitzki2,4,12; Christian

Homann2,12; Wilfried Eberhardt3,12; Michael Forsting5,12; Ken

Herrmann1,6,12; Dirk Theegarten7,12; Servet Bölükbas8,12; Clemens Aigner9;

Kaid Darwiche10,12; Martin Stuschke1,2,11,12; Martin Schuler1,3,11,12

1DKTK Standort Essen, Essen, Deutschland

2Klinik und Poliklinik für Strahlentherapie, Universitätsklinikum Essen, Essen,

Deutschland

3Innere Klinik (Tumorforschung), Essen, Deutschland

4Klinik und Poliklinik für Radioonkologie und Strahlentherapie, TUM, München,

Deutschland

5Institut für Diagnostische und Interventionelle Radiologie und Neuroradiologie,

Essen, Deutschland

6Klinik für Nuklearmedizin, Essen, Deutschland

7Institut für Pathologie, Essen, Deutschland

8Klinik für Thoraxchirurgie und Thoraxendoskopie, Westdeutsches

Krebszentrum, Universitätsmedizin Essen - Ruhrlandklinik, Universitätsklinikum

Essen, Universität Duisburg-Essen, Essen, Deutschland

9Klinik für Thoraxchirurgie, Comprehensive Cancer Center, Medizinische

Universität Wien, Wien, Österreich

10Klinik für Pneumologie, Interventionelle Bronchologie, Essen, Deutschland

11DKFZ, Heidelberg, Deutschland

12Nationales Centrum für Tumorerkrankungen (NCT) West, Essen, Deutschland.

Background: In oligometastatic non-small cell lung cancer (OMDLC),

locally advanced tumor extension is an unfavorable prognostic factor.

e aim of this study is to determine long-term prognosis in OMDLC

aer loco-regional radiochemotherapy (RCT) and to compare it with

patients (pt) with locally advanced stage-III NSCLC aer introduction of

immune-checkpoint inhibitors (ICIs) and new precision radiotherapeutic

techniques.

Methods: All consecutive pts, who received induction-chemotherapy

(INDCTX) and combined RCT from 01/2017 to 02/2020 were included.

Results: A total of 288 pts met inclusion criteria: 220 presented with stage-

III (158 with def.RCT, 62 with a trimodality approach), 68 with OMDLC.

Overall survival (OS) at 5 years was 34.9% (95%CI: 27.4%-42.8%) for pts

with NSCLC stage-III and def. RCT, 28% (95%CI: 16.8%-40.2%) for the

OMD cohort (p= 0.1570). ECOG, ICI-line and age as well as CRP-values

are important prognostic parameters for OS (p< 0.03). Comparing meta-

static-site in pairwise-correlation in the whole cohort there were striking

dierences in OS (p= 0.0042), especially OS was better in pts with solitary

brain metastases. During the same period, 39 pts with NSCLC stage-III

were treated with INDCTX, def.RCT and primary durvalumab consoli-

dation. Among OMDLC pts, 14.1% received immunotherapy as part of

initial multimodality therapy.

Discussion: OS of pts with cT4/cN2-3 cM0 tumors and durvalumab-con-

solidation aer def.RCT was signicantly better than of the remaining

pts at 4/5years: 75.1±8.9% and 65.7±11.7%, respectively (p< 0.001). With

modern staging methods, a signicant percentage of pts present with

OMDLC. In OMDLC with solitary metastasis or ICI prognosis was better

than without, especially in pts with solitary brain metastases.

Conclusion: Long-term survival between pts with OMDLC selected at the

center for radical thoracic therapy and primarily technically or function-

ally inoperable stage-III pts was comparable. In pts with PD-L1 expression

early inclusion of immune-check point inhibitors may improve survival

outcomes.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 129

544

Process evaluation of the implementation of the DigiNet

intervention: Facilitating and inhibiting factors

Vanessa Mildenberger1; Leonie Eilers2; Florian Kron2,3,4; Anna Kron3,5;

Jürgen Wolf3,5; Anika Kästner6; Wolfgang Homann6; Anna Spier1;

Dusan Simic1; Stephanie Stock1

1Institute for Health Economics and Clinical Epidemiology, Faculty of Medicine

and University Hospital Cologne, University of Cologne, Cologne, Deutschland

2KCM KompetenzCentrum für Medizinoekonomie, FOM Hochschule für

Oekonomie & Management gemeinnützige Gesellschaft mbH, Essen,

Deutschland

3Department I of Internal Medicine, Center for Integrated Oncology (CIO)

Aachen Bonn Cologne, Faculty of Medicine and University Hospital Cologne,

Cologne, Deutschland

4VITIS Healthcare Group, Cologne, Deutschland

5National Network Genomic Medicine (nNGM) Lung Cancer, Faculty of Medicine

and University Hospital Cologne, Cologne, Deutschland

6Institute for Community Medicine, Section Epidemiology of Health Care and

Community Health, University Medicine Greifswald, Greifswald, Deutschland

Background: e project DigiNet aims at improving personalized lung

cancer care in Germany through digital connection of specialized academic

centers with practitioners via a shared project database. is is used to trans-

mit molecular diagnostics from the centers to determine, monitor and guide

targeted therapy. Furthermore, patient-reported outcomes are evaluated.

As this new form of care is a complex intervention, process evaluation is

required, which will examine the implementation. For this purpose, facili-

tating and inhibiting factors as determinants of change were identied.

Methods: Since project start qualitative interviews were conducted with

health care providers. A semi-structured interview guide was used, which

was developed based on a systematic literature review. e data material

was analyzed using MAXQDA according to Mayring’s qualitative content

analysis.

Results: 15 Interviews were conducted via Zoom with treating oncologists

and study assistants. e close networking of all project participants, espe-

cially with the specialized centers as well as the documentation of treat-

ment data in a more structured manner using the database were identied

as facilitating factors. Patients can benet from having their condition

systematically assessed through patient-reported outcomes. Inhibiting

factors include a high burden of bureaucratic processes, especially those

related to patient information and consent.

Discussion: Practitioners can guide targeted therapy more eectively as

the database leads to a more structured documentation and digitalization

facilitates networking of cooperating practitioners. is improves patient

care. However, due to the additional eort during the project period, the

integration of the complex intervention into existing treatment structures

is still challenging.

Conclusion: e results of the process evaluation demonstrate that

DigiNet, as a new form of care, has the potential to dynamically improve

personalized lung cancer therapy.

Disclosure Statement: e authors declare no conict of interest.

571

Six-year survival and HRQoL outcomes with 1L nivolumab

(N) + ipilimumab (I) vs chemotherapy (C) in patients with

metastatic NSCLC (mNSCLC) from CheckMate227

Suresh S. Ramalingam1; Tudor-Eliade Ciuleanu2; Reyes Bernabe Caro3;

Makoto Nishio4; Hideaki Mizutani5; Jong-Seok Lee6; Clarisse Audigier-

Valette7; Randeep Sangha8; Laszlo Urban9; Jacobus A. Burgers10;

Adam Pluzanski11; Ki Hyeong Lee12; Bogdan Zurawski13; Michael

Schenker14; Solange Peters15; Luis Paz-Ares16; Hossein Borghaei17;

Kenneth O’byrne18; Julie R. Brahmer19; Ravi G. Gupta20; Judith Bushong20;

LI LI20; Yong Yuan20; Steven Blum20; Martin Reck21

1Winship Cancer Institute, Emory University, Atlanta, USA

2Institutul Oncologic Prof. Dr. Ion Chiricuta and University of Medicine and

Pharmacy Iuliu Hatieganu, Cluj-Napoca, Rumänien

3Hospital Universitario Virgen del Rocio, Instituto de Biomedicina de Sevilla,

Seville, Spanien

4Cancer Institute Hospital of the Japanese Foundation for Cancer Research,

Tokyo, Japan

5Saitama Cancer Center, Saitama, Japan

6Seoul National University Bundang Hospital, Seongnam, Republik Korea

7Hôpital Sainte Musse, Toulon, Frankreich

8Cross Cancer Institute, Edmonton, Kanada

9Mátrai Gyógyintézet, Matrahaza, Ungarn

10The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital,

Amsterdam, Niederlande

11Maria Sklodowska-Curie National Research Institute of Oncology,

Warsaw, Polen

12Chungbuk National University Hospital, Cheongju-si, Republik Korea

13Ambulatorium Chemioterapii, Bydgoszcz, Polen

14Sf Nectarie Oncology Center, Craiova, Rumänien

15Lausanne University Hospital, Lausanne, Schweiz

16Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid,

Madrid, Spanien

17Fox Chase Cancer Center, Temple Health, Philadelphia, USA

18Princess Alexandra Hospital, Translational Research Institute and Queensland

University of Technology, Brisbane, Australien

19Bloomberg–Kimmel Institute for Cancer Immunotherapy, Johns Hopkins

Kimmel Cancer Center, Baltimore, USA

20Bristol Myers Squibb, Princeton, USA

21Airway Research Center North, German Center for Lung Research,

LungenClinic Grosshansdorf, Grosshansdorf, Deutschland

Background: In CheckMate 227 Pt 1 (NCT02477826), 1L N + I showed

long-term durable OS benet vs C in pts with mNSCLC. Here we present

6-y outcomes, including association of OS with response/tumor burden

reduction and HRQoL.

Methods: Adults with tx-naive stage IV/recurrent NSCLC, no known

EGFR/ALK alterations, and ECOG PS ≤1 were enrolled. Pts were ran-

domized 1:1:1 to N + I, N, or C (tumor PD-L1 ≥1%) or N + I, N + C,

or C (tumor PD-L1 <1%). Assessments included OS, PFS, ORR, DOR,

and OS by best response and tumor burden reduction from baseline

(responders: complete/partial response [CR/PR] with ≥80% reduction, PR

with 50–<80% reduction, or PR with 30–<50% reduction; non-respond-

ers: stable/progressive disease) and by baseline HRQoL using EQ-5D-3L

(higher scores indicated better HRQoL).

Result: At 73.4 mo min follow-up (f/u; database lock: Feb 21, 2023), N + I

continued to show OS benet vs C in pts with tumor PD-L1 ≥1% or <1%;

6-y OS rates were 22% vs 13% and 16% vs 5%, respectively. Consistent

clinical benet was noted across additional ecacy endpoints in all pts

regardless of tumor PD-L1 status and in pts alive at 6 y. More responders

had tumor burden reduction ≥80% with N + I vs C (tumor PD-L1 ≥1%:

15% vs 3%; tumor PD-L1 <1%: 8% vs 1%); 6-y OS rates were also higher

(59% vs 42%; 77% vs 0%). In pts who completed EQ-5D-3L visual analog

scale assessments with 61.3 mo min f/u (n = 1073), median (95% CI) OS

was longer in those with high vs low (relative to the median) baseline

scores, regardless of tx (N + I: 19.7 [16.7–23.9] vs 14.9 [12.2–18.1] mo;

C: 17.8 [15.0–19.8] vs 10.1 [7.8–12.2] mo). OS by response/tumor burden

reduction in additional categories and updated 6-y HRQoL data will be

presented. No new safety signals were noted.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts130

Discussion: is 6-y update represents the longest f/u across 1L immuno-

therapy trials in mNSCLC.

Conclusion: N + I continued to show long-term durable ecacy benet

vs C in pts with tumor PD-L1 ≥1% or <1% (a population with high unmet

need). Responders with higher tumor burden reduction had greater long-

term OS benet with N + I vs C. Better baseline HRQoL was also associ-

ated with improved OS.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

576

Patients’ perspective on tolerability of dostarlimab in NSCLC:

patient-reported outcomes from the Phase II PERLA trial

Martin Reck1; Ana Laura Ortega Granados2; Filippo de Marinis3; Qin Shen4;

Susan Boklage4; Christine Dabrowski4; Lillian Cho4; Oren Meyers4;

Frank Griesinger5

1Lungen Clinic, Airway Research Center North, Center for Lung Research,

Grosshansdorf, Grosshansdorf, Deutschland

2Hospital Universitario de Jaén, Servicio de Oncología Médica, Español, Spanien

3European Institute of Oncology, Milan, Italien

4GSK, Collegeville, PA, USA

5Klinik für Hämatologie und Onkologie, Universitätsklinik für Innere Medizin –

Onkologie, Pius-Hospital, Oldenburg, Deutschland

Background: In PERLA trial (NCT04581824), dostarlimab+chemo-

therapy (DCT) showed similar ecacy to pembrolizumab+CT (PCT)

as rst-line treatment (Tx) for patients (pts) with metastatic non-onco-

gene-driven, non-squamous, non-small cell lung cancer (NSCLC); the

proportion of pts experiencing Tx-related adverse events or AEs leading to

Tx discontinuation was similar between groups [1]. Exploratory analyses

of pt-reported measures of tolerability were conducted.

Methods: Pts (ECOG 0–1) were randomized 1:1 to ≤35 cycles (C) of DCT/

PCT every 3 weeks (Q3W) (CT: ≤35 C of 500 mg/m2 pemetrexed + ≤4

C of cisplatin/carboplatin). Patient-reported outcome version of CTCAE

(PRO-CTCAE) and tolerability item of FACT-G (FACT-GP5) were col-

lected at Day 1 C1, then Q3W to W12, Q9W to W48, Q12W to end of Tx,

at end of Tx, and 30-day safety follow-up.

Results: Completion rates for PRO-CTCAE (DCT N=96/PCT N=88) and

FACT-GP5 (DCT N=95/PCT N=87) were >80% up to C4, then reduced

in both arms. At baseline (BL), only the urinate frequently item had >10%

of pts reporting occurrence as “frequently” or greater per PRO-CTCAE

(DCT: 11.5%; PCT: 10.2%); “severe” or greater severity and “quite a bit”

or greater interference responses were reported in <10% of pts. At C13

(~1 yr of Tx) urinate frequently was similar between arms (“frequently”

or greater in DCT: 12.5%; PCT: 10%). Relative to BL, at C13 muscle and

joint ache frequency, severity and interference responses of “quite a bit”

or greater were increased in both arms, but occurred in <16% of pts. Per

FACT-GP5, at BL 85.3/94.3% of DCT/PCT pts were “not at all” or “a little

bit” bothered by Tx side eects; at C13 this was 77.4/84.2% and no pts in

either arm were “very much” bothered.

Conclusion: Most pts reported little/no bother from Tx side eects and

responses were similar across Tx arms, suggesting Tx are tolerable from pt

perspective. ese results supplement previous PERLA data and support

further investigation of dostarlimab plus existing and novel Tx in meta-

static NSCLC.

Indication of source:

1. Peters S, et al. 2022; Oral; ESMO-IO (7–9 Dec, Geneva).

Disclosure Statement: e authors declare the following: Abbvie, Amgen, Ariad,

AstraZeneca, Beigene, BMS, Bristol Myers-Squibb, Boehringer-Ingelheim, Celgene,

Daiichi-Sankyo, GSK, Janssen Lilly, LLC, Merck, MSD, Novartis, Pzer, Regeneron,

Roche, Samsung.

632

Prospective observational study of advanced lung cancer

patients treated with a combination of pembrolizumab and

Viscum album L. extract (PHOENIX-III)

Klaudia Kunc1; Marcus Reif2; Ulrike Weissenstein3; Claudia Leichnitz4;

Timo Weiß4; Katarzyna Blazejczyk4; Hannah Wüstefeld4; Harald Matthes4;

Christian Grah4

1Vivantes Humboldt-Klinikum, Berlin, Deutschland

2Gesellschaft für Klinische Forschung e.V., Berlin, Deutschland

3Verein für Krebsforschung e.V., Arlesheim, Schweiz

4Gemeinschaftskrankenhaus Havelhöhe Klinik für Anthroposophische Medizin,

Berlin, Deutschland

Background: First data suggest a benecial eect of add-on treatment

with Viscum album extract (VA) in advanced lung cancer patients. e

primary objective of this study was to evaluate the safety prole and e-

cacy of the combination therapy of immune checkpoint inhibitor pem-

brolizumab and VA (PVA) in patients with advanced non-small cell lung

cancer (NSCLC).

Methods: A prospective longitudinal observational study was conducted

with metastatic, unresectable NSCLC, Eastern Cooperative Oncology

Group (ECOG) performance status 0-2, and PVA combination therapy.

Adverse events (AEs), Trial Outcome Index (TOI) of the Functional

Assessment of Cancer erapy-Lung questionnaire, tumor response, qual-

ity of life, and survival were followed and evaluated for at least six months

and analyzed with descriptive statistics.

Result: 103 patients with advanced NSCLC treated at a German lung can-

cer center were enrolled in the study between 2017-2021 in a sub-analysis,

43 NSCLC patients with programmed death ligand 1(PD-L1) expression

>50% (mean age = 69 years, 98% Caucasian, 56% male, 81% non-squa-

mous, 14% ECOG:2, 37% smokers) rst-line treated with PVA were evalu-

ated. e median duration of PVA therapy was 6.0 months. A total of 133

AEs of any grade were observed in 39 (91%) patients during treatment,

including 25 serious AEs in 19 (45%) patients. A total of 25 immune-

related adverse drug reactions (iADRs) were identied in 15 patients

(35%), with 22 iADRs causally related to pembrolizumab and three to VA.

Four patients (9%) discontinued treatment due to ADR. e mean TOI

(±SD) of the 43 patients was 49 (± 17) at baseline, 57 (± 18) at 3 months,

and 55 (± 14) at 6 months.

Discussion: ICIs provide clinical benets in advanced cancers, but usually

they are associated with a remarkable spectrum of iADRs. ADR- and dis-

continuation rates in the PHOENIX-III cohort will be compared to rates

reported in the literature for pembrolizumab monotherapy.

Conclusion: Further studies to evaluate the clinical ecacy, safety and

management of iADRs on combination therapy should be pursued in

larger study cohorts.

Disclosure Statement: e authors declare the following: wirtschalich.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 131

636

Treatment patterns in patients with stage III NSCLC: Results

from the regional cancer registry Baden-Wuerttemberg

Bernd Mühling1; Pengfei Xu1; Julia Häberlin2,2; Franziska Kanz2;

Eugen Tausch3; Cornelia Kropf-Sanchen3; Anna Babiak3; Christina Babiak1

1Klinik für Herz-, Thorax- und Gefäßchirurgie, Uniklinik Ulm

Ulm, Deutschland

2Klinische Landesregisterstelle des Krebsregisters Baden-Württemberg,

Stuttgart, Deutschland

3Comprehensive Cancer Center Ulm, Ulm, Deutschland

Background: erapy of locally advanced lung cancer in UICC stage III

is multimodal. e aim of our study was to assess treatment patterns in

those patients in south west Germany and to evaluate whether multimodal

treatment is realized throughout the region.

Methods: Retrospective analysis of patients with stage III NSCLC in terms

of primary treatment and overall survival. As for primary treatment all

patients treated between 2015 bis 2021 were considered, as for overall sur-

vival the time frame from 2015 to 2018 was studied.

Result: Between 2015 and 2021 a total of 42.557 patients were diag-

nosed lung cancer in Baden-Wuerttemberg. Of these 6784 patients were

included for descriptive analysis, 5.444 for survival analysis. In 22%

(1479/6784) no information about primary treatment was available. In

registered patients single therapy (surgery alone, chemotherapy alone

or radiotherapy alone) was performed in 44% (2351/5305), multimodal

treatment (incl. surgery, radio- chemotherapy, immunotherapy) in 56%

(2954/5305). Median overall survival for stages IIIA, IIIB and IIIC was

26.2 vs. 17.5 vs. 10.5. months. Adenocarcinomas showed signicantly

better survival in men and in women.

Discussion: Although recording of patients in regional cancer registries

is not obligatory our data analysis demonstrates for the rst time real-

world treatment patterns in patients with stage III NSCLC in southwest

Germany.

Conclusion: Despite clear guidelines multimodal treatment of patients

with NSCLC UICC III is not satisfactorily realized. It is not clear why

a huge proportion of patients does not receive multimodal treatment

approaches. However results might be biased as there is no obligation for

registering patients in cancer registries.

Disclosure Statement: e authors declare no conict of interest.

674

Tumor Treating Fields (TTFields) therapy with standard

systemic therapy in metastatic non-small cell lung cancer

following progression on or after platinum-based therapy:

global, randomized, pivotal (phase 3) LUNAR study

Richard Greil1; Ticiana Leal2; Rupesh Kotecha3; Rodryg Ramlau4; LI Zhang5;

Janusz Milanowski6; Manuel Cobo7; Jaromir Roubec8; Lubos Petruzelka9;

Libor Havel10; Jerey Ward11; Sujith Kalmadi12; Zoran Andric13;

Thierry Berghmans14; David Gerber15; Goetz Kloecker16; Rajiv Panikkar17;

Joachim Aerts18; Angelo Delmonte19; Miklos Pless20; Christian Rolfo21;

Wallace Akerley22; Michael Eaton23; Mussawar Iqbal24; Corey Langer25

1Salzburg Cancer Research Institute-Center for Clinical Cancer and Immunology

Trials (SCRI-CCCIT); Paracelsus Medical University Salzburg; Cancer Cluster,

Salzburg, Österreich

2Winship Cancer Institute at Emory University, Atlanta, USA

3Miami Cancer Institute, Baptist Health South Florida, Miami, USA

4Poznan University of Medical Sciences, Poznan, Polen

5Sun Yat-sen University Cancer Center (SYSUCC), Guangzhou, China, VR

6Medical University of Lublin, Lublin, Polen

7Medical Oncology Intercenter Unit, Regional and Virgen de la Victoria

University Hospitals, IBIMA, Malaga, Spanien

8Nemocnice AGEL Ostrava-Vítkovice, Ostrava, Tschechische Republik

9General University Hospital in Prague, Prague, Tschechische Republik

10Thomayer Hospital, Prague, Tschechische Republik

11Washington University School of Medicine, St. Louis, USA

12Ironwood Cancer & Research Centers, Chandler, USA

13Clinical Hospital Centre Bezanijska Kosa, Belgrade, Serbia

14Jules Bordet Institute, Hôpitaux Universitaires de Bruxelles, Université Libre de

Bruxelles, Brussels, Belgien

15Harold C. Simmons Comprehensive Cancer Center, UT Texas Southwestern

Medical Center, Dallas, USA

16University of Louisville, Louisville, USA

17Geisinger Cancer Institute, Danville, USA

18The Erasmus MC Cancer Institute, Erasmus University Medical Center,

Rotterdam, Niederlande

19IRCCS Istituto Romagnolo per lo Studio dei Tumori “Dino Amadori” (IRST),

Meldola, Italien

20Kantonsspital Winterthur, Winterthur, Schweiz

21Center for Thoracic Oncology, Tisch Cancer Institute at Icahn School of

Medicine, Mount Sinai, USA

22Huntsman Cancer Institute, University of Utah, Salt Lake City, USA

23St Francis Hospital, Indianapolis, USA

24College of Medicine, University of Saskatchewan, Saskatoon, Kanada

25Abramson Cancer Center, Perelman School of Medicine, University of

Pennsylvania, Philadelphia, USA

Background: TTFields are electric elds that disrupt cancer cell viabil-

ity. TTFields therapy is approved for glioblastoma and mesothelioma. e

randomized, pivotal (phase 3) LUNAR study (NCT02973789) assessed the

ecacy and safety of TTFields therapy with investigator’s choice of stand-

ard systemic therapy (ST; immune checkpoint inhibitor [ICI] or docetaxel

[DTX], standard of care at time of study design) for metastatic non-small

cell lung cancer (mNSCLC) progressing on/aer platinum-based therapy.

Methods: Adult patients were randomized 1:1 to TTFields+ST or ST.

Primary endpoint: overall survival (OS); key secondary endpoints: OS in

ICI and DTX subgroups; other secondary endpoints: adverse events (AEs)

and patient-reported HRQoL assessed from baseline to 54 weeks by the

validated EORTC QLQ-C30 questionnaire.

Result: 276 patients (TTFields+ST, n=137; ST, n=139) were included.

Median (m) age was 64 years (range, 22–86), 64% were male, 57% had

non-squamous NSCLC, 96% had ECOG PS 0–1, 10% had >1 prior line

of ST, and 32% had prior ICI. Characteristics were balanced between

arms. OS was signicantly extended with TTFields+ST vs ST: mOS

(95% CI) 13.2 (10.3–15.5) vs 9.9 (8.1–11.5) months (mo); HR 0.74 (95%

CI 0.56–0.98); P=0.035. In the ICI subgroup (n=134), TTFields therapy

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts132

signicantly improved OS vs ICI alone: mOS (95% CI) 18.5 (10.6–30.3)

vs 10.8 (8.2–18.4) mo; HR 0.63 (95% CI 0.41–0.96); P=0.030. In the DTX

subgroup (n=142), mOS (95% CI) with TTFields+DTX vs DTX was 11.1

(8.2–14.1) vs 8.7 (6.3–11.3) mo; HR 0.81 (95% CI 0.55–1.19); P=0.28.

AEs were similar for TTFields+ST (97%) vs ST (91%). 71% reported a

device-related AE; 6% were grade 3. For global health status, there was no

clinically meaningful (≥10 points) decline in either treatment group, or

dierence between treatment groups.

Discussion: TTFields therapy plus ST extended OS vs ST without exacer-

bating systemic toxicities or adversely aecting HRQoL in patients with

mNSCLC progressing on/aer platinum-based therapy.

Conclusion: ese results warrant TTFields therapy as an option to man-

age mNSCLC in this setting.

Disclosure Statement: e authors declare that there are conicts of interest.

econicts were submitted to the congress organizer KUKM GmbH and KUKM

can disclose them if needed.

685

Concordance on treatment recommendations from

multidisciplinary tumor boards – Data from driver-mutated

lung cancer patients in focus

Julia Roeper1; Jan Wagner2; Frank Griesinger1

1Universität Oldenburg/Pius Hospital, Oldenburg, Deutschland

2UKE Hamburg, Hamburg, Deutschland

Background: Multidisciplinary tumor boards (MTB) aim at developing

the best possible treatment plan according to guidelines of national med-

ical societies while considering the individual patient’s case. For this pur-

pose, every patient should be discussed in a MTB. e aims of the study

were to investigate the frequency of dierent degrees of concordance (full,

partial, non-concordance), the potential dierence in concordance in

driver-mutated patients and the overall survival associated with dierent

degrees of concordance.

Methods: Data from 644 patients with lung cancer discussed in tumor

boards were documented and evaluated according to the concordance on

MTB recommendations. 75/644 (12%) of these patients showed a driver

mutation. Clinical characteristics were compared using Fischer’s chi-square,

t-test, or exact test. Correlations between concordance rate and overall sur-

vival were exploratory using Kaplan-Meier survival analyses. Multilevel

analysis and Cox regression models will be presented at the conference.

Result: e overall concordance rate was 85% (545/644). Patients with a

driver mutation (n=53 patients with an EGFR 19/21 mt; n=15 patients

with an EML4 ALK translocation; n=9 patients with a BRAF mt; n=2

patients with a ROS1 mt) had a concordance rate of 91% (69/75) com-

pared to 85% concordance rate of the overall cohort. Patients with a com-

plete concordance to the MTB recommendation had an OS of 17 months

(n=545) compared to 4 months (n=99) for patients with a discordant

treatment (p<0.001). e driver-mutated concordant treated patients had

a longer OS of 21 months vs. 2 months for patients with a discordant treat-

ment (p<0.001).

Conclusion: Patients with a concordant treatment had a signicant lon-

ger OS as patients with a discordant treatment. e concordance rate

was higher in the group of driver-mutated patients and patients with a

driver-mutation and a concordant treatment showed a longer OS as

patients without. Assessment of concordance to MTB recommendations

could become a meaningful and reproducible quality criterion for cancer

centers in Germany.

Disclosure Statement: e authors declare the following: Präsentationshonorar

AstraZenca, BoehringerIngelheim.

689

First-line (1L) nivolumab (N) plus ipilimumab (I) with two

cycles of chemotherapy (chemo) in patients with metastatic

non-small cell lung cancer (mNSCLC): Results from an interim

analysis of the non-interventional FINN study

Jonas Kuon1; Eyck von der Heyde2; Marina Bischo3; Stefan Wilop4;

Dirk Behringer5; Wolfgang Blau6; Gerdt Hübner7; Dimitri Flieger8;

Helmut Forstbauer9; Matthias Groschek10; Heinz-Eckart Laack11;

Harald Müller-Huesmann12; Christian Schumann13;

Daniela Waldenberger14; Sylvia Gütz15

1SLK Fachklinik Löwenstein, Lowenstein, Deutschland

2Onkologie am Raschplatz, Hannover, Deutschland

3Klinikum Idar-Oberstein GmbH, Idar-Oberstein, Deutschland

4MVZ West GmbH Würselen, Würselen, Deutschland

5Augusta Kranken Anstalt gGmbH, Bochum, Deutschland

6Helios Dr. Horst Schmidt Kliniken Wiesbaden, Wiesbaden, Deutschland

7ohO-ostholstein Onkologie, Oldenburg in Holstein, Deutschland

8GPR Klinikum Rüsselsheim, Rüsselsheim, Deutschland

9GOSPL Gesellschaft für onkologische Studien, Praxismanagement und Logistik,

Troisdorf, Deutschland

10Clinical Research Stolberg GmbH, Stolberg, Deutschland

11Studiengesellschaft Hämato-Onkologie Hamburg, Hamburg, Deutschland

12Klinik für Hämatologie und Onkologie, Brüderkrankenhaus St. Josef Paderborn,

Paderborn, Deutschland

13Klinikverbund Allgaeu gGmbH, Kempten and Immenstadt, Deutschland

14Bristol Myers Squibb Deutschland, München, Deutschland

15St. Elisabeth-Krankenhaus Leipzig, Leipzig, Deutschland

Background: e CheckMate 9LA study showed that N + I with 2 cycles

of chemo vs chemo alone signicantly improved overall survival (OS) for

patients (pts) with mNSCLC. e FINN real-world study (NCT04794010)

aims to evaluate this regimen in clinical practice in Germany.

Methods: Enrollment for the prospective, observational study is ongoing,

with 90 sites and 650 pts planned in Germany. Pts ≥18 y old with mNSCLC

are eligible if they began 1L N + I with 2 cycles of chemo per the approved

EMA label. During the planned ≤5-y follow-up period (from treatment

[tx] initiation until death, withdrawal of consent, loss of follow-up, or end

of study), assessments will be conducted per routine local clinical prac-

tice. e primary endpoint is OS. Secondary endpoints include progres-

sion-free survival, tx duration, patient characteristics, and safety.

Result: At the interim analysis (Jan 31, 2023), 256 pts were enrolled

(median follow-up: 5.6 mo). Median (range) age was 67 (43–86) y;

46.9%, 39.8%, and 12.9% of pts were <66, 66–75, and >75 y old, respec-

tively. Most pts were male (60.9%), current/former smokers (81.6%),

had an ECOG performance status of 0 or 1 (84.4%), and had non-squa-

mous tumor histology (63.7%). e median number of metastases was 2

(range, 0–12). Most pts (67.6%) had extrathoracic metastases (M1b/M1c

disease) with brain and liver metastases in 19.9% and 19.1%, respectively.

Few pts had received prior therapy, including radiotherapy (18.8%), sur-

gery (17.2%), or systemic therapy/chemo (12.9%). Tx-related adverse

events (AEs) of all grades occurred in 53.9% of pts, and tx-related

severe AEs occurred in 17.6% of pts. ere was 1 tx-related death from

immune-mediated hepatitis. We will present updated data with longer

follow-up (data cuto July 2023).

Discussion: is study will provide valuable real-world insights on tx with

N + I with 2 cycles of chemo in mNSCLC.

Conclusion: e FINN study will describe patient characteristics, ecacy,

safety prole, and tx patterns of 1L N + I with 2 cycles of chemo in clini-

cal practice in Germany. At interim analysis, pts had a manageable safety

prole.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 133

700

Increasing liquid biopsy sensitivity to the next level: usability

of minimal residual disease detection by longitudinal

genomic fusion tracing using specic digital droplet PCR

(ddPCR) in non-small cell lung cancer (NSCLC) treated with

immune checkpoint inhibition (ICI) +/- chemotherapy

Frank Griesinger1; Julia Roeper1; Tobias Overbeck2; Kay Willborn3; Philipp

Ströbel2; Thomas Asendorf2; Jessica Halfen2; Heiko Golpon4; Ekke Schütz5;

Srushti Borkar1; Fenja Markus6; C. Vössing6; P. Weist6; Lukas Heukamp6

1Universität Oldenburg/Pius Hospital, Oldenburg, Deutschland

2UMG Göttingen, Göttingen, Deutschland

3Pius Hospital, Oldenburg, Deutschland

4MHH Hannover, Hannover, Deutschland

5GmbH an Oncocyte Company, Göttingen, Deutschland

6Lungenkrebsmedizin Oldenburg GbR, Oldenburg, Deutschland

Background: erapy monitoring in NSCLC has the potential to inform

optimal therapy in the metastatic and the non-metastatic curative setting.

It has been shown in many studies, that drop of detection of ctDNA is

associated with a better prognosis in patients treated with ICI and also in

driver mt+ positive tumors. In the non-metastatic setting, the presence

of residual disease aer surgery, induction therapy or radio-chemother-

apy could potentially be used to decide on further interventions such as

adjuvant therapy, escalation of therapy or maintenance therapy, respec-

tively. However, in most cases in the non-metastatic setting, detection of

ctDNA is hampered by limited sensitivity of ctDNA assays. Recently it

has been shown in neuroblastoma, that genomic breakpoints of frequent

somatic chromosomal rearrangement can be used to generate tumor spe-

cic ddPCR assays for minimal residual disease (MRD) detection. As

NSCLC is routinely comprehensively analyzed for mutations and fusions,

in more than 90% of NSCLC specic non-druggable fusions are detected

by hybrid capture assays.

Methods: erefore, we plan to investigate the usability of generating

breakpoint specic ddPCR primers in 40 NSCLC IV pts treated in the

palliative setting with ICI +/- chemotherapy: ddPCR primers are derived

from tumor specic genomic breakpoints and will be tested at 3 dierent

time points during the course of 1st line treatment, i.e. prior to systemic

therapy, at 6 and 9 weeks on therapy and at progression. Correlation of

ddPCR MRD monitoring results will be done for ORR, PFS and OS within

the eraSure CNI-Monitor Trial conducted by the CCC-N. Trial start to

recruit in August 2023.

Result: Clinical characteristics of the pts, Kaplan-Meier survival analyses

and Cox regression models will be presented at the conference.

Conclusion: Establishing a minimally invasive, low-cost diagnostic proce-

dure to detect and monitor MRD has the potential to provide a more com-

prehensive view of the risk of relapse in pts, allowing clinicians to adapt

treatment approaches earlier, with the goal of improving cancer survival.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

739

Genetic expression and prognostic impact of PIK3CA-gene

mutations (exon 9 and exon 20) in patients with stage IV

non-small cell lung cancer (NSCLC)

Darko Katalinic1; Ivan Aleric1; Aleksandar Vcev1; Lars Toetome2

1Faculty of Dental medicine and Health and Faculty of Medicine, University of

Osijek, Osijek, Kroatien

2Center for Cancer Medicine, Oslo, Norwegen

Background: e phosphatidylinositol 3-kinase (PI3K) plays an important

role in cell proliferation. It consists of a regulatory and a catalytic subu-

nit; the latter one is encoded by 3 genes including PIK3CA, PIK3CB, and

PIK3CD. e PIK3CA mutations are the most frequent in cancers. In non-

small cell lung cancer (NSCLC), mutations withinPIK3CAdomain usu-

ally aect the helical binding (exon 9) or the catalytic domain (exon 20),

and they are considered oncogenic. e aim of our study was to assess the

frequency and signicance of PIK3CA mutations (exon 9 and exon 20)

among the patients with NSCLC and to compare the data to clinicopatho-

logical and molecular features.

Methods: e study was performed among 270 patients (62.4% males and

37.6% females; mean age of 54.47 ± 16.37 years) with diagnosis of stage IV

NSCLC. Tumor tissue was analyzed forPIK3CA, BRAF and KRAS muta-

tions using quantitative real-time polymerase chain reaction restriction

fragment length polymorphism assay.

Result: We identied 11 (4.1%) patients withPIK3CAmutations in exon

9 and exon 20. ese mutations were found with a higher frequency in

sqamous cell carcinoma (11.7%) compared to adenocarcinoma (3.1%,

p<0.001). e most commonPIK3CAmutation was exon 9 E545K and it

was related to poor progression-free survival (PFS) (P= 0.021) and poor

cancer-specic survival (CSS) (P= 0.005). No correlation to overall sur-

vival (OS) was observed (P= 0.006). ere was strong correlation between

PIK3CA and BRAF and KRAS mutational status (P = 0.001).

Discussion: Our study showed that PIK3CA (exon 9 and exon 20) muta-

tion rate is in accordance with previously published data. Furthermore,

the PIK3CA (exon 9 and exon 20) mutational status was an independent

risk factor for PFS and CSS of patients with NSCLC and was in strong

correlation with BRAF and KRAS mutational status.

Conclusion: e poor prognosis of patients with singlePIK3CAmutation

in NSCLC and the prognostic value ofPIK3CA, KRAS and BRAFmuta-

tions should be determined for individual therapeutic strategies in

NSCLC.

Disclosure Statement: e authors declare no conict of interest.

755

Addressing systemic rst line therapy of elderly lung cancer

patients is critical

Konstantinos Ferentinos1; Jan Volmerig2; Georg Nilius3; Birgit Jaeger4;

Andreas Koziorowski5; Imke Stoever5; Daniel Christoph1

1Department of Medical Oncology and Oncological Palliative Care, Evang.

Kliniken Essen-Mitte, Essen, Deutschland

2Department of Thoracic Surgery, Evang. Kliniken Essen-Mitte, Essen,

Deutschland

3Department of Pneumology, Evang. Kliniken Essen-Mitte, Essen, Deutschland

4MVZ Strahlentherapie, Alfried-Krupp-Krankenhaus Essen, Essen, Deutschland

5Strahlentherapie Ruhr, Essen, Deutschland

Background: At the time of diagnosis, the majority of the lung cancer

(LC) patients (pts) are old and have comorbidities. ey are underrepre-

sented in clinical trials and have limited therapy options.

Methods: In our retrospective data analysis we included all pts older than

75 years with LC regardless of stage treated at a DKG-certied LC cen-

tre and primary LC diagnosis from 2017 until 2022. Progression-free and

overall survival, objective response rate, and adverse events (AEs) result-

ing in therapy discontinuation were assessed for pts with systemic therapy.

Results: 365 out of all 1.837 newly diagnosed LC pts from 2017 to 2022

were older than 75 years. Of these, 115 pts (31.5%) underwent primary

surgery and 15 pts (4.1%) primary radiotherapy; 143 pts (39.2%) received

systemic treatment and 92 pts (25.2%) had best supportive care. 43 pts

(11.8%) suered from small cell LC and 322 pts (88.2%) from non-small

cell LC. 99 pts with systemic therapy (69.2%) received combined chemo-/

immunotherapy, 31 pts (21.7%) immunomonotherapy and 13 pts (9.1%)

a small molecule inhibitor. 22 pts with systemic therapy (15.4%) had an

ECOG performance status (PS) of 0, 80 pts (56 %) a PS of 1, 36 pts (25.1%)

a PS of 2 and 5 pts (3.5%) a PS of 3. All elderly pts with high PD-L1

expressing tumours received immunomonotherapy. 89 of 99 pts (90%)

with chemo-/immunotherapy received platinum-based chemotherapy. Of

these, 30 pts (30%) had to stop therapy prematurely due to AEs.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts134

Discussion: For pts whose tumour expresses lower levels of PD-L1 (TPS

<50% or ICS <10%) combined platinum-based chemo-/immunotherapy

is the recommended rst line therapy, but elderly pts are usually unt to

get these therapies at the regular dosage. A single-agent immunotherapy

might be eective in some cases but is only approved for pts with high

PD-L1 expressing tumours (TPS ≥50% or ICS ≥10%).

Conclusion: Many elderly pts received combined chemo-/immunother-

apy, but therapy was oen prematurely stopped due to AEs. A quarter of

the pts with systemic therapy had a PS of 2.

Disclosure Statement: e authors declare the following: Beratungstätigkeit/

Honorare: Boehringer, Glaxo, Berlin Chemie, AstraZeneca, Bayer, Boehringer-

Ingelheim, Bristol-Myers Squibb, Chugai, MSD Merck, Sharp & Dohme, Novartis,

Novocure, Pzer, Roche, Sano, Takeda.

885

Prognostic biomarkers improve selection of SCLC patients for

second line treatment with Topotecan

Laura Lambrecht; Toki Bolt; Jürgen Behr; Amanda Tufman;

Diego Kaumann-Guerrero

LMU Klinikum München, München, Deutschland

Background: SCLC is a highly aggressive tumor and overall survival (OS)

remains poor despite intensive eorts to develop new treatment strategies.

Especially in second line topotecan is the only approved drug with a mOS

of 5.9 month. However, real-world SCLC patients are oen in worse con-

dition and harbor more comorbidities than study populations. erefore,

the real world performance of, topotecan may dier from that seen in

studies. Here, we analyzed outcomes of SCLC patients receiving topotecan

and identied predictive and prognostic markers.

Methods: We retrospectively analyzed 44 SCLC patients receiving topo-

tecan between 2015 and 2022. We analyzed baseline characteristics (age,

ECOG-PS, topotecan cycles and dosage) and pre-treatment blood values

(LDH, CRP, sodium) as well as prognostic scores (neutrophil/lymphocyte

ratio (NLR), thrombocyte/lymphocyte ratio, Glasgow Prognostic Score,

prognostic nutritional score, systemic inammation index (SII) and the

prognostic index) extracted from electronic patients’ charts to identify

prognostic markers.

Result: mPFS and mOS was 1.9 and 5.6 months respectively in the whole

cohort. ECOG-PS (p>0.001), NLR (p=0.001) and SII (p=0.008) were sig-

nicant independent prognostic variables in a multivariate COX regres-

sion model. Selecting patients by these three markers achieved a mPFS

of 5.7 and thus increased the mPFS 3-fold in comparison to the whole

cohort. Patients not meeting all criteria had a PFS of 1.8 months (p=0.006).

Patients identied by prognostic markers had a mOS of 8.1 months.

Discussion: e ecacy of topotecan in SCLC real-world patients is very

poor indicating that many patients were treated without any benet. Easy

to obtain markers can predict response and treatment ecacy and should

therefore be validated in larger cohorts to identify patients more probable

to benet from topotecan.

Conclusion: Due to the limited ecacy and high potential for side eects,

the selection of SCLC patients for second-line topotecan treatment might

be guided by easy to obtain markers.

Disclosure Statement: e authors declare no conict of interest.

893

Benchmark of screening markers for KEAP1/NFE2L2

mutations and joint analysis with the K1N2-score

Christoph Arolt1; Andreas Calaminus1; Margaret Dugan2; Robert Wild2;

Vanessa Richartz1; Barbara Holz1; Johannes Brägelmann1,3,4,5; Svenja

Wagener-Ryczek1; Sabine Merkelbach-Bruse1,6; Jürgen Wolf6,7; Reinhard

Büttner1,6; Luigi Catanzariti2; Matthias Scheer6,7; Axel Hillmer1,3

1Institute of Pathology, University of Cologne, Faculty of Medicine and

University Hospital Cologne, Köln, Deutschland

2Dracen Pharmaceuticals Inc., San Diego, CA, USA

3Center for Molecular Medicine Cologne, University of Cologne, Köln,

Deutschland

4Mildred Scheel School of Oncology, University of Cologne, Faculty of Medicine

and University Hospital Cologne, Köln, Deutschland

5Department of Translational Genomics, University of Cologne, Faculty of

Medicine and University Hospital Cologne, Köln, Deutschland

6Lung Cancer Group Cologne, Center for Integrated Oncology Cologne/Bonn,

University Hospital Cologne, Köln, Deutschland

7Department I for Internal Medicine, Center for Integrated Oncology Cologne/

Bonn, University Hospital Cologne, Köln, Deutschland

Background: Non-small-cell lung cancer (NSCLC) with KEAP1/NFE2L2-

pathway activation is a distinct NSCLC group characterized by poor clin-

ical outcome. We recently developed a unifying transcriptomic signature

(K1N2-score) that robustly detects pathway activation status and KEAP1/

NFE2L2 mutation status allowing for potential patient selection in a pre-

cision medicine setting. As the clinical availability of multi-gene RNA

sequencing might be limited, we evaluated NQO1 immunohistochemis-

try (IHC) and RNA expression data of single genes as potentially more

accessible screening approaches.

Methods: mRNA of 348 in-house FFPE samples were quantied with a

custom NanoString mRNA panel. 232 of these tumors were analyzed with

NQO1 IHC and scored. mRNA Expression of the top ve K1N2-Score

genes and NQO1, as well as NQO1 IHC were evaluated to predict the

KEAP1/NFE2L2 mutation status. Using a validation dataset (mRNA =

108; IHC n = 89), all markers were tested alone or as a screening marker,

which, if positive, was followed by validation with the K1N2-score.

Result: While NQO1-IHC alone predicted the mutation status with a

moderate Youden’s J of 0.33 (sensitivity + specicity -1), the predictive

power was increased through K1N2-score validation (J = 0.69, Sens =

0.84, spec = 0.85) and was similar to the K1N2-score alone (J = 0.73, sens:

0.9, spec: 0.83). Both tests were outperformed by the combination of either

of NQO1, TRIM16 or TXNRD1 RNA with the K1N2-Score (J = 0.75, 0.74

and 0.73, respectively).

Discussion: Combined testing of NQO1 IHC and the K1N2-score had

a comparable performance as the K1N2 score alone when predicting

KEAP1/NFE2L2 mutations status. is approach required 23 less (- 26%)

K1N2-score analyses while adding the cost of 89 IHC. However, the com-

bined testing of NQO1 mRNA and the K1N2-score outperformed all

other approaches.

Conclusion: Combination of NQO1 IHC with the K1N2-Score is a feasi-

ble, potentially more cost-ecient test strategy than the K1N2 score alone.

However, quantitative NQO1 mRNA testing should be evaluated as alter-

native screening test in clinical samples.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 135

899

Development and validation of a brief questionnaire to assess

lung cancer-specic health competence (gesa-NSCLC)

Thomas Elter1,2; Carolin Groß-Opho-Müller2,3; David Hoier2,4;

Andreas Greeske2; Jonas Heidelbach2; Heinz-Wilhelm Esser2;

Michael Hallek1; Marcus Redaèlli5; Christopher Kofahl6

1University of Cologne, Department I of Internal Medicine, Center for Integrated

Oncology Aachen Bonn Cologne Duesseldorf, Cologne, Deutschland

2Onqo Health GmbH, Cologne, Deutschland

3Kliniken der Stadt Köln gGmbH, Cologne, Deutschland

4St. Martinus Krankenhaus, Duesseldorf, Deutschland

5Institut für Gesundheitsökonomie und Klinische Epidemiologie, Uniklinik Köln,

Cologne, Deutschland

6Zentrum für Psychosoziale Medizin, Institut für Medizinische Soziologie,

Universitätsklinikum Hamburg-Eppendorf, Hamburg-Eppendorf, Deutschland

Purpose: One third of lung cancer patients do not receive the best stand-

ard of care. Besides guideline-concordant treatment, adequate health lit-

eracy is a key criterion for optimal outcome. An established instrument

for assessing cancer-specic health literacy is the gesa-k questionnaire

and the Brief Generic Cancer Knowledge Scale (BCKS-10) that based on

it. However, no brief questionnaire is available to specically assess health

literacy in lung cancer patients.

Methods: In order to better reect the reality of care for lung can-

cer patients, we specied two questions of BCKS-10 for developing the

gesa-NSCLC questionnaire. A rst data analysis of 355 healthy individuals

that participated in an online survey served for validation.

A second analysis compared both results of the gesa-NSCLC (healthy

population) with BCKS-10 (cancer patients) to dene the treatment-

related increase of cancer-specic health literacy.

Results: Final questionnaire consists of 10 questions. In terms of item dis-

crimination, the corrected item-total correlation of 8 out of 10 items were

above the threshold of 0.3. Cronbach’s alpha of about 0.68 revealed an

acceptable internal consistency as the tool is brief and consists of dierent

dimensions.

Discussion: Since people with cancer have to deal with very specic infor-

mation on diagnosis and therapy, more specic survey instruments are

consequently necessary. However, no brief questionnaire exists to date

that can measure lung cancer-specic health literacy. e gesa-NSCLC

questionnaire was developed to enable an even more specic survey of

health literacy in people with lung cancer.

Conclusion: We developed and validated the rst brief health literacy

questionnaire gesa-NSCLC designed specically for patients with lung

cancer.

Disclosure Statement: The authors declare the following: Thomas Elter is

founder and CEO of Onqo Health GmbH Carolin Groß-Ophoff-Müller is a

research assistant at Onqo Health GmbH David Hoier is a research associate at

Onqo Health GmbH, Jonas Heidelbach is CMO and Adreas Greeske the CTO

of Onqo Health.

914

Clinical applications of circulating tumor cells in non-small cell

lung cancer

Varun Gupta1; Ka-Won Noh2

1Lungenklinik Hemer Abteilung für Thoraxchirurgie, Hemer, Deutschland

2Pathologie Uniklinik Köln, Köln, Deutschland

Despite curative treatment, around 30–55% of NSCLC patients relapse,

primarily at distant sites, and 50% succumb to lung cancer. Circulating

tumor cells (CTC) get dislodged from the primary tumor or metastatic

sites and circulate in the bloodstream.

CTC positivity was associated with poor overall survival (OS) and dis-

ease-free survival (DFS). CTC counts signicantly increase in the pulmo-

nary vein aer surgical manipulation of the tumor or even endoscopic

biopsy.

A systemic review and metaanalysis by Wankhede et al. published

Cancers in 2022, showed that CTC status was highly predictive of the

survival outcomes of patients with early-stage NSCLC. Specically,

CTC+ status had a negative impact on OS, regardless of time and source

of blood collection, detection methods, and follow-up duration. Meta-

analytic data showed that CTC status was highly predictive of the sur-

vival outcomes and had a negative impact on DFS, regardless of time and

source of blood collection, detection methods, and follow-up duration.

In addition, it was found that the pathological stage was associated with

CTC status, with stage III patients more likely to be CTC+, whereas stage

I was at a lower risk.

As the stage progressed from early to advanced, the likelihood of CTC+

increased accordingly. Stage I disease was least likely to be associated

with CTC resembling the classical view of the impact of the stage on

CTC. Moreover, CTC count correlated with the pathologic stage in a

similar way.

ese ndings hint towards the increased shedding of CTC from the

bulky tumor and multiple nodal metastases. is result also conforms to

the current evidence on the association of CTC to tumor size and lymph

node metastasis.

To conclude, CTC could be a valid prognostic indicator for OS and DFS.

Pre- and Post-OP CTC analysis can guide percision therapy. Timing of

surgery and neo-adj. or adj. therapy can be based on CTC values. CTC

could be used as a marker for recurrence survelience and response to

therapy.

Disclosure Statement: e authors declare no conict of interest.

947

Recurrence of locally advanced NSCLC after

radiochemotherapy and consolidative Durvalumab - A

german multicenter retrospective analysis

Lea Reitnauer1; Georg Evers1; Daniel Christoph2; Wolfgang Brückl3; Marcel

Wiesweg4; Franziska Glanemann4; Maximilian Webendörfer4; Cornelia

Kropf-Sanchen5; Fabian Acker6; Wolfgang Schütte7; Petra Hoknecht8;

Andrea Kerkho1; Michael Mohr1; Georg Lenz1; Nikolaj Frost9; Tobias

Overbeck10; Martin Sebastian6; Annalen Bleckmann1

1University Hospital Münster, Department of Medicine A - Hematology,

Oncology and Pneumology, Münster, Deutschland

2Kliniken Essen-Mitte, Department of Medical Oncology/Haematology, Essen,

Deutschland

3Paracelsus Medical University, General Hospital Nuremberg

3Department of Respiratory Medicine, Allergology and Sleep Medicine /

Nuremberg Lung Cancer Center, Nürnberg, Deutschland

4University Hospital Essen, University Duisburg-Essen, Department of Medical

Oncology, West German Cancer Center, Essen, Deutschland

5University of Ulm, Department of Pulmonology, Internal Medicine II, Ulm,

Deutschland

6Goethe University Frankfurt, University Hospital, Department of Hematology

and Oncology, Frankfurt/Main, Deutschland

7Martha-Maria Krankenhaus Halle-Dölau, Department of Internal Medicine II,

Halle (Saale), Deutschland

8Niels-Stensen-Kliniken Franziskus-Hospital Harderberg, Georgsmarienhütte,

Deutschland

9Charité - Universitätsmedizin Berlin (Corporate Member of Freie Universität

Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health),

Department of Infectious Diseases and Pulmonary Medicine, Berlin,

Deutschland

10University Medical Center Göttingen, Department of Hematology and Medical

Oncology, Göttingen, Deutschland

Background: Although some progress has been made in the treatment of

locally advanced non-small cell lung cancer (NSCLC), disease progres-

sion or recurrence remains common in most patients. However, to date,

there are no established standards for further therapeutic approaches in

relapsed/refractory (r/r) NSCLC. Here, we present real world data from

patients with r/r NSCLC.

Methods: Data from 122 patients from 10 German lung cancer centers

was analyzed retrospectively. e patients were treated for r/r NSCLC

aer radiochemotherapy and consolidative durvalumab between 06/2017

and 07/2023. Overall survival (OS) and progression-free survival (PFS)

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts136

were calculated for the entire patient population and compared in relation

to the salvage therapy selected.

Result: Median OS of the total cohort aer initial diagnosis of NSCLC

was 25.8 mths (95%-CI 20.6 - 30.9). Aer disease recurrence, median OS

and PFS were 11.7 (95%-CI 9.2 - 14.2) and 6.4 mths (95%-CI 5.2 - 7.6),

respectively. e majority of patients received systemic therapy (70.5%).

e choice of therapeutic agents varied between checkpoint inhibitors

(with and without chemotherapy, 34.9%), platinum-based chemotherapy

(30.2%) and single agent chemotherapy (27.9%). Few patients received

targeted therapy (7.0%). OS was higher in the group of patients who

received checkpoint inhibitor-based therapy than in the groups of patients

who received other systemic therapies (median OS 23.8 vs. 10.8 mths,

p= 0.003). Moreover, our data indicate that OS might be inuenced by

ECOG status (p <0.001) and site of recurrence (intra- vs. extrathoracic,

p = 0.003).

Discussion: r/r NSCLC is associated with a poor prognosis. Our analy-

sis suggests that continuation of immunotherapy might be benecial in

patients with r/r NSCLC. However, our data should be interpreted with

caution due to its retrospective character.

Conclusion: Prospective clinical trials are needed to optimize treatment

strategies in patients with r/r NSCLC and to identify parameters that

determine prognosis.

Disclosure Statement: e authors declare no conict of interest.

Molecular Pathology

301

WAYFIND-R: A global, real-world database of patients

(pts) with a solid tumour proled with next-generation

sequencing (NGS)

Uwe M. Martens1; Jean-Yves Blay2; Allan Hackshaw3; Christophe Le

Tourneau4; Jan Geissler5; Anna Ferro6; Erika Schirghuber6; Olga Skatkova6;

Rodrigo Dienstmann7

1SLK-Kliniken Heilbronn GmbH, Heilbronn, Deutschland

2Centre Léon Bérard, Lyon, Frankreich

3UCL Cancer Institute, London, United Kingdom

4Institut Curie, Paris, Frankreich

5Patvocates GmbH, Munich, Deutschland

6F. Homann-La Roche Ltd, Basel, Schweiz

7Vall d’Hebron Institute of Oncology, Barcelona, Spanien

Background: WAYFIND-R is a global, multicenter, prospective pan-can-

cer registry collecting long-term data from pts diagnosed with a solid

tumour proled with NGS. e goal is to advance precision medi-

cine by providing high-quality real-world data (RWD) to researchers

internationally.

Methods: WAYFIND-R data are electronically collected into a centralised

database with standardised forms and high quality data management pro-

cedures. To ensure reliability/accuracy and a t-for-purpose data source,

data are periodically evaluated. Enrolment began in Sep 2020. Sites submit

baseline pt, tumour, biomarker, NGS and molecular tumour board (MTB)

decision making at enrolment, and treatment and outcome data at routine

follow up.

Result: As of 31 Mar 2023, 855 pts had completed baseline data collec-

tion and cancer-related information; 755 carried on to the next data col-

lection, 119 had died and 18 had ended participation. Pts were enrolled

at 61 sites across 23 countries, mostly at academic institutions/university

hospitals. e median age was 65 years (range: 20–93), 50% were female,

49% were retired and 62% had government insurance. WAYFIND-R had

109 cancer types and 160 subtypes (most common: adenocarcinoma

[n = 389]). e most commonly detected genes were TP53, KRAS, EGFR,

BRAF and APC. e most commonly screened non-NGS biomarkers

were cytokeratin 7 (CK7/KRT7), PD-L1, CA19-9, CEA and Ki67. Many

pts (n = 341; 40%) had not been evaluated by an MTB. e most frequent

MTB recommendation aer NGS testing (n = 213; 25%) was to start

other treatment (chemotherapy: 63%; immunotherapy: 19%; targeted

therapies: 18%).

Conclusion: e WAYFIND-R registry captures precision oncology data

using a standardised approach globally. WAYFIND-R can enable further

insights into clinical decision making, the timeliness of NGS testing and

access to therapy.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

403

Principal-agent theory-based survey of the care and

reimbursement situation of molecular diagnostics in

non-small cell lung cancer in the German inpatient sector

Melina Sophie Kurte1,2; Ann-Cathrine Siefen2; Robert Dengler3;

Florian Kron2,4,5,6

1Faculty of Medicine, University of Duisburg-Essen, Essen, Deutschland

2VITIS Healthcare Group, Cologne, Deutschland

3OncoLogic Healthcare Consulting GbR, Nittendorf, Deutschland

4Center for Integrated Oncology (CIO ABCD), Faculty of Medicine and University

Hospital of Cologne, University of Cologne, Cologne, Deutschland

5FOM University of Applied Sciences for Economics and Management, Essen,

Deutschland

6Department I of Internal Medicine, Faculty of Medicine and University Hospital

Cologne, University of Cologne, Cologne, Deutschland

Background: Molecular diagnostics of tissue or liquid biopsies are guide-

line-based prerequisites for the provision of targeted (personalized) ther-

apies in non-small cell lung cancer. However, current register studies show

limited test rates in Germany. Outside of the existing trans-sector Specic

Care Contract (SCC) §140a SGB V, molecular diagnostics is reimbursed

in the outpatient but not in the inpatient setting. e aim was hence to

determine the general oer and reimbursement structures of molecular

diagnostics in Germany.

Methods: Based on the assumptions of the principal-agent theory, a path-

way of reimbursement for molecular diagnostics was illustrated from a

hospital perspective. All hospitals treating patients with the ICD-10-GM

diagnosis C34.- ‘lung cancer’ were surveyed using the German Hospital

Directory. Applicable outpatient reimbursement was assigned to each

hospital, subdivided by number of hospital beds and patients treated.

Result: In 2020, lung cancer patients were treated in 1,001 hospital loca-

tions (889 hospitals). 52% of the hospitals (n=462) had no reimbursement

for outpatient services. 89% of these hospitals (n=413) had ≤ 500 beds.

Of 171,824 hospitalized cases, 32% (n=55,826) were treated in hospitals

without reimbursement for outpatient services. Of these cases, 81% were

in hospitals with ≤ 500 beds (n=45,260).

Discussion: e analysis shows numerous hospitals that face economic

burdens without inpatient reimbursement of molecular diagnostics. SCC

§140a SGB V demonstrates a model for trans-sectoral reimbursement

combined with control for quality-assured testing, clinical information,

and thus cancer care. Current hospital reform may change reimbursement

structures in Germany. Concomitant centralization of oncology treat-

ments could enable more patients to access personalized therapies.

Conclusion: Given the clinical benets of molecular testing and per-

sonalized treatment, quality-adjusted reimbursement structures should

be secured in all treatment settings. e national Network Genomic

Medicine is a model example of this.

Disclosure Statement: e authors declare the following: A.-C. Siefen,

J.Trümmler and F. Kron are employees of VITIS GmbH, which was funded by

Noscendo GmbH in connection with the development of this abstract. e funder

of the study had no role in study design, data collection/analysis/interpretation, or

writing of the abstract.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 137

521

Analysis and annotation of next generation sequencing data

with the database Cancer Genome Interpreter

Christoph Jonas1; Jana Fassunke1; Michaela A. Ihle1; Nadina Ortiz-Brüchle2;

Angela Maurer2; Martin Kirschner3; Sabine Merkelbach-Bruse1

1University of Cologne, Faculty of Medicine and University Hospital Cologne,

Köln, Deutschland

2University Hospital of Aachen, Faculty of Medicine, Institute of Pathology,

Aachen, Deutschland

3Department of Hematology, Oncology, Hemostaseology and Stem cell

transplantation, University Hospital RWTH Aachen, Aachen, Deutschland

Background: Cancer Genome Interpreter-Clinics (CGI-Clinics) is a

community-driven database project that aims to improve personalized

medicine in oncology by optimizing genomic data interpretation using

a systematic approach. CGI-Clinics is a European research initiative ini-

tiated by Dr. Nuria Lopez-Bigas and her team (Institute for Research in

Biomedicine, Barcelona) focusing on annotation and interpretation of

variants of unknown signicance and patient empowerment.

Methods: e rst phase of the study is divided into two objectives: 1)

adapting the CGI tool to make it more applicable and accessible for clini-

cal practice and 2) optimizing the machine learning-based algorithms to

interpret the relevance of cancer mutations. For both objectives, somatic

tumor mutations from patients identied by next generation sequencing

(NGS) are used.

Result: CGI-Clinics identies the likely driver alterations in cancer

genes in the tumor type using computational methods (BoostDM and

OncodriveMut). Biomarkers of response to anti-cancer drugs are identi-

ed according to several databases.e special feature of the project is the

increased focus on patients making data and results more accessible. CGI-

Clinics will develop a virtual molecular tumor board and build “eduCGI”,

an app for patients.

Discussion: Data maintenance will remain a challenge as science evolves

and new biomarkers are identied. In this regard further challenges of

CGI clinics are the harmonization of sequencing- and metadata to make

it interoperable for cancer genomics research.

Conclusion: CGI Clinics platform will be a huge benet for cancer

management and personalized medicine by optimizing genomic data

interpretation. Patients will have the opportunity to gain a better under-

standing of their disease and be encouraged to make their data available

for research purposes. is project received funding from the EU Horizon

program HORIZON-HLTH-2021-CARE-05-02 under grant agreement

No. 101057509.

Disclosure Statement: e authors declare no conict of interest.

584

Impact of reference materials on analytical performance

evaluation of liquid biopsy NGS assays and its direct

implications for clinical diagnosis

Thomas Keßler1,2; Ariane Hallermayr1,2,3; Moritz Fujera1; Ben Liesfeld4;

Samuel Bernstein4; Simon von Ameln5; Denny Schanze6; Verena Steinke-

Lange1,2,3; Julia MA Pickl1,3; Teresa Neuhann1; Elke Holinski-Feder1,2,3

1MGZ – Medizinisch Genetisches Zentrum, München, Deutschland

2European Liquid Biopsy Society, Hamburg, Deutschland

3Medizinische Klinik und Poliklinik IV, Campus Innenstadt, Klinikum der

Universität München, München, Deutschland

4Limbus Medical Technologies GmbH, Rostock, Deutschland

5Immune-Oncological Centre Cologne (IOZK), Köln, Deutschland

6Institute of Human Genetics, University Hospital Magdeburg, Otto-von-

Guericke University, Magdeburg, Deutschland

Background: Liquid biopsy (LB) enables non-invasive analysis of genetic

tumor variants in circulating free DNA (cfDNA) in plasma to support per-

sonalized treatment. Most cancer patients present with actionable tumor

variants in plasma with variant allele frequencies (VAFs) <1%. us,

accurate analytical validation of LB assays at the lower end of the meas-

urement scale is mandatory to maximize clinical assay utility, particularly

regarding the In Vitro Diagnostic Regulation (IVDR). Selection of appro-

priate reference materials is the rst and key prerequisite for this purpose.

Methods: Six types of commercial cfDNA reference materials and 42 patient

samples were analyzed using a duplex sequencing-based LB NGS assay.

Firstly, we evaluated the similarity of the reference materials to native cfDNA.

Secondly, we determined the material’s background noise, a step critical for

accurate assessment of precision and sensitivity of the analytical assays.

Result: We observed signicant dierences between reference materials

in terms of wet-lab and sequencing quality as well as in background noise.

No reference material resembled native cfDNA in all performance metrics

investigated. Based on our results, we established guidelines for the selec-

tion of appropriate reference materials for improved LB assay validation.

Discussion: Careful consideration of reference materials is required for

dierent steps of LB assay validation. Similarity to native cfDNA aids the

development of experimental protocols, while reference materials with

well-dened variants and low background noise are preferable for determin-

ing assay precision and sensitivity. As none of the tested reference material

proved optimal for all validation steps, our proposed guidelines support the

implementation of appropriately validated LB assays in clinical diagnostics.

Conclusion: e use of appropriate reference materials and detection cut-

os is required to ensure optimal sensitivity for variant detection in LB

assays facilitating accurate clinical interpretation across laboratories.

Disclosure Statement: e authors declare no conict of interest.

598

Multi-omics analysis to uncover the molecular basis of tumor

budding in head and neck cancer

Iordanis Ourailidis1,2; Fabian Stögbauer3; Katja Steiger3; Susanne Beck1;

Wilko Weichert3; Peter Schirmacher1; Albrecht Stenzinger1;

Melanie Boxberg3; Jan Budczies1

1Pathologisches Institut, Universitätsklinikum Heidelberg, Heidelberg,

Deutschland

2Faculty of Biosciences, Heidelberg University, Heidelberg, Deutschland

3Institut für Pathologie, Technische Universität München, München,

Deutschland

Background: Tumor budding (TB) evaluated by the analysis of histo-

pathological slides is associated with lymph node metastasis and unfa-

vorable prognosis in HPV+ and HPV- head and neck squamous cell

carcinoma (HNSCC) [1]. e molecular mechanisms underlying TB are

incompletely understood.

Methods: We analyzed digital histopathological slides, mutation data,

transcriptomics data, and survival data of HNSCC from TCGA (n=325).

Gene lists were compiled to include genes showing signicant (FDR=5%)

Spearman correlations of at least R=0.25 of mRNA expression with TB.

Gene set enrichment with respect to 50 hallmarks gene sets was carried

out separately for the lists of positively and negatively correlating genes.

Protein expression of CAV1 and MMP14 was analyzed using immunohis-

tochemistry in an independent cohort (n=41).

Result: TB was associated positively with TP53 mutations in HPV+

tumors and negatively with NSD1 mutations in HPV- tumors. In HPV+

HNSCC, 786 genes correlated signicantly with TB, while in HPV-

HNSCC 422 genes correlated signicantly with TB. e positively corre-

lating genes in HPV+ HNSCC were enriched for epithelial-mesenchymal

transition (EMT), while the negatively correlating genes were enriched for

two categories related to proliferation. e positively correlating genes in

HPV- HNSCC were enriched for EMT, coagulation, hypoxia, and further

categories, while there was no enrichment for the negatively correlating

genes. e correlation of CAV1 and MMP14 with TB observed in the

TCGA could be validated in the independent cohort. e proteins were

expressed as follows: low in tumors w/o TB, intermediate in the bulk of

tumors with TB, and high in tumor buds.

Discussion: We conrmed an association of TB and epithelial-mesenchy-

mal transition that was reported in earlier studies.

Conclusion: Molecular correlates of TB were uncovered in a system-

atic analysis combining histopathology and -omics data. e detected

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts138

markers, in particular CAV1 and MMP14, warrant further evaluation as

biomarkers.

Reference:

[1] Stögbauer F et al., Br J Cancer. 2023, 128(12):2295.

Disclosure Statement: e authors declare the following: JB and MB: funding by

the German Cancer Aid (grants 70113973 and 70113976). JB: consulting fees by

MSD. MB: consulting fees by BMS. AS: grants by Bayer, BMS, Chugai, and Incyte.

AS: Advisory Boards/Speaker’s Bureau: Agilent, Aignostics, Amgen, Astra Zeneca,

Bayer, BMS, Eli Lilly, Illumina, Incyte, Janssen, MSD, Novartis, Pzer, Qlucore,

Roche, Seagen, Takeda, ermo Fisher. PS: funding by Roche, Chugai, BMS,

Novartis. PS: Advisory Board/Speaker’s Bureau: Astra Zeneca, Incyte, Janssen.

736

Implementation of a customized Easy®PGX qPCR assay for

fast-track analysis of lung cancer samples

Svenja Wagener-Ryczek; Roberto Pappesch; Jana Fassunke;

Christoph Jonas; Michaela A. Ihle; Carina Heydt; Janna Siemanowski;

Vanessa Welter; Sabine Merkelbach-Bruse; Udo Siebolts

Uniklinik Köln Institut für Pathologie, Köln, Deutschland

Background: e detection of somatic gene variants, splicing variants and

targetable fusions plays and important role in cancer precision medicine.

With improvement of multiplex DNA and RNA-based sequencing meth-

ods, the spectrum of molecular targets tested increased. e major draw-

back is the increasing turnaround time until delivery of results. To face

the demand for comprehensive best standard molecular diagnostics with

a fast therapy decision, the implementation of a fast-track analysis upfront

NGS-based analyses oers a solution

Methods: For the detection of variants and fusions, a customized qPCR

assay system was applied on an Easy®PGXplatform. In brief, 10ng DNA

and 15ng RNA extracted separately from formalin-xed paran-embed-

ded (FFPE) tissue samples were taken as input for each reaction well of

the customized Easy®PGX fast-track assay (Diatech Pharmacogenetics

S.R.L). Data analysis was performed with the Easy®PGX soware for

DNA and RNA.

Result: Using the above described fast-track system, 750 DNA and 750 RNA

samples were analysed. Variants in EGFR exon 19, insertions in EGFR exon

20, BRAF Codon V600 and KRAS codon 12 variants were analysed on DNA

level, whilst well-evaluated and targetable fusions in ALK, RET and ROS

as well as MET exon 14 skipping were analysed on RNA level. Individual

thresholds of ct values were evaluated and detection limits were identied.

Discussion: is study aimed to evaluate the technical feasibility of ana-

lyzing therapeutically relevant molecular targets in lung cancer samples.

Particularly, the study tested the robustness and detection limits of each

variant- and fusion assays included. Individual thresholds of ct values for

each assay and the eective application of downstream validation assays

completes the need for fast delivery of molecular results with high preci-

sion and sensitivity of molecular testing.

Conclusion: is method demonstrated robust detection of rst-line ther-

apeutically relevant target aberrations leading to faster therapy decision

and complements molecular diagnostics via larger NGS-based methods.

Disclosure Statement: e authors declare no conict of interest.

757

The Genomic Evolution of Recurrence Development in

Chordoma - A Whole Exome Study Comparing Primary Tumors

and Long-Term Recurrences

Sarah Rebecca Ullmann; Albert Roessner; Julian Schreier;

Sabine Franke; Dörthe Jechorek; Franziska Karras

Universitätsklinikum Magdeburg, Institut für Pathologie, Magdeburg,

Deutschland

Chordomas are rare malignant bone tumors, with a high recurrence rate.

ere is no data on the genomic landscape of long-term recurrences.

erefore, we performed a whole exome sequencing study (WES), to

detect alterations that aren’t included in targeted panels. We investigated

four patients with multiple recurrences over seven to 16 years and eight

patients with primary, sacral chordomas in order to compare both groups

as well as the recurrence cases to each other. Our aim was to nd genomic

dierences between primary and recurrent tumors and identify driver

mutations of long-term recurrences. Aer histopathological classication

and immunohistochemical staining, DNA and miRNA was extracted from

formalin-xed-paran-embedded (FFPE) tissue samples. e DNA was

analysed by WES using a NextSeq high-throughput sequencing instrument,

the miRNA via Nanostring. MiRNA regulation patterns showed similari-

ties within cases with long- term recurrences. Our WES analysis conrmed

previously described driver genes and revealed possible new driver genes

next to broad alterations in pathways eecting embryonic and notochordal

development. Histologically all cases were of conventional type. While no

dierences could be observed on histological grounds, genomic distinctions

were obvious. Primary cases displayed a dierent distribution of genomic

mutations, showing remarkably fewer disturbances in embryonic signaling

and our proposed driver genes. Intriguingly, our study found a progress in

number of alterations throughout the recurrences most of all eecting chro-

matin regulatory but also in FAT, GRM and the HOX family. Less disrup-

tion of these pathways in primary cases than in recurrences implies their

pivotal role not only in chordoma formation, but also in recurrence evolu-

tion. Combined genomic and clinical studies, concentrating on embryonic

signaling, chromatin regulation, and our proposed new driver genes, could

expand understanding of recurrence development and possibly lead to new

therapeutic targets inhibiting or delaying recurrence formation.

Disclosure Statement: e authors declare no conict of interest.

774

Determining MSI status of prostate and cholangiocellular

carcinoma by genome wide NGS

Janna Siemanowski; Peony Poon; Udo Siebolts;

Sabine Merkelbach-Bruse

Uniklinik Köln Institut für Pathologie, Köln, Deutschland

Background: In order to nd new therapeutic targets, genomewide-next

generation sequencing (NGS) approaches for the analysis of multiple

biomarkers are used. Microsatellite instability (MSI) is one of them. As

validated cut-os are not available for a wide range of entities we aimed

to establish suitable thresholds for prostate (PCa) and cholangiocellular

carcinoma (CCC).

Methods: For mismatch repair (MMR) immunohistochemistry (IHC)

tumor sections were stained for MLH1 (Clone: M1, Ventana), MSH2

(G219-1129), MSH6 (EPR3947) and PMS2 (Clone: 44, Ventana) on a

Ventana Benchmark stainer. For MSI analysis, the TruSight Oncology 500

Kit was used (Illumina). Sequencing was performed using the Nextseq

or Novaseq (Illumina). MSI analysis of 130 noncoding homopolymer

regions was done with the TSO500 Local App (Illumina), analysis of addi-

tional di-, tri- and tetranucleotid repeats was done with MSIsensor-pro1.

Result: 44 CCC and 59 PCa samples were analysed. Using published

thresholds (20-30% of unstable MSI loci)2,3, one CCC and no PCa were

identied as MSI-High (MSI-H). Another CCC case and two PCa cases

harbouring mutations in MLH1, MSH2 or MSH6 were identied as

MSI-H aer MMR IHC testing. In these samples, percentage of unstable

loci ranged from 3.23% (CCC) to 7.26-13.76% (PCa).

Discussion: Since MSI proles can dier between cancer entities, thresh-

olds for instability must be determined for each of them individually4.

Especially when using mononucleotide markers small shis might be

missed. Here we showed that already published cut-os calculated for

other entities cannot be easily transferred to PCa and CCC.

Conclusion: MSI estimation using NGS is suitable as a quick screening

tool. Since thresholds for MSI-H might dier enormously between enti-

ties, additional IHC testing is recommended at least in samples where

VUS or pathogenic mutations are found in one of the mismatch repair

genes.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 139

Indication of source:

1 Peng et al., GPB 2020.

2 Zhao et al., bioRxiv 2020.

3 Kroeze et al., J Mol Diagn. 2020.

4 Siemanowski et al., Cancers 2021.

Disclosure Statement: e authors declare no conict of interest.

778

Utility of miRNA miR-371a-3p for the early detection of

metastases in testicular germ cell tumors

Roberto Pappesch; Felix Seelemeyer; Sabine Merkelbach-Bruse;

Axel Heidenreich; Udo Siebolts

Uniklinik Köln, Köln, Deutschland

Purpose: Eective management of testicular germ cell tumors (GCTs)

involves monitoring of serum tumor markers like AFP, beta HCG, and

LDH. However, 50-60% of GCTs do lack these markers, causing challenges

for clinical decisions. MicroRNAs (miRNAs), particularly miR-371a-3p,

have emerged as promising GCT biomarkers due to their high sensitivity

and specicity (≥90%) compared to conventional biomarkers. Initial data

suggest superiority of this marker in monitoring potential progression.

To explore the potential for early metastasis detection in seminomas and

nonseminomas, miRNA levels were tracked from December 2021 to pres-

ent, correlating measurements with metastasis occurrence for 16 patients.

Methods: Sixteen patients with marker-negative clinical stage (CS)

IIA/B seminomas (n=10) and nonseminomas (n=6) underwent primary

nerve-sparing retroperitoneal lymph node dissection (nsRPLND). Blood

samples collected pre-surgery were processed following standart oper-

ation protocols. miRNA was extracted and puried using the Maxwell

RSC MiRNA Plasma and Serum Kits (Promega). Following manufactur-

ers protocol (mirdetect) miR-371a-3p and the endogenous control miR-

30b-5p were reverse transcribed to cDNA. Quantitative polymerase chain

reaction was performed on the Roche Lightcycler 480 II. Results were

documented as relative quantity (RQ) values.

Results: Histology showed metastatic seminoma/nonseminoma in 12/16

(75%) cases. Non-malignant conditions, teratoma, and lymphoma were

found in 4 patients. miR-371 positivity was 100% (12/12) in metastatic

patients and 75% (3/4) in non-metastatic cases. One patient with small

volume CS IIA seminoma showed false negative results.

Discussion: is study underscores miR-371’s utility as a personalized

biomarker predicting small volume retroperitoneal lymph node metasta-

ses in CS IIA/B seminomas and nonseminomas.

Conclusion: Positive ndings suggest that miR-371 expression is a good

predictive biomarker and should result in active treatment, while negative

results warrant vigilant follow-up.

Disclosure Statement: e authors declare no conict of interest.

844

The Role of BMP/TGF-β Signaling in the Development of

Dedierentiated Chondrosarcoma

Franziska Karras; Julian Schreier; Sarah Rebecca Ullmann;

Sabine Franke; Albert Roessner; Dörthe Jechorek

Universitätsklinik Magdeburg - Institut für Pathologie, Magdeburg, Deutschland

Background: Dedierentiated chondrosarcoma (DDCS) is a rare and

aggressive cartilage tumor originating out of a low-grade chondrosarcoma.

e typical histological characteristic is a coexistence of a well-dierenti-

ated and a dedierentiated component. Despite the obvious histological

dierences, the underlying mechanisms of DDCS development are widely

unknown. In a preliminary study, we identied dierential expressed miR-

NAs in the dedierentiated components in comparison to the well-dif-

ferentiated components of paired DDCS samples [1]. Validated targets of

these miRNAs are components of BMP/TGF-β signaling. erefore, we

performed a genomic and epigenetic analysis of 10 DDCS cases with focus

on BMP/TGF-β signaling.

Methods: We extracted DNA and miRNA from FFPE tissue samples of

DDCS. e DNA was analyzed by WES and miRNA expression by the

miRNA Expression Panel for the NanoString nCounter MAX analysis sys-

tem. Immunohistochemical expression of BMPR2, TGFBR2 and SMADs

was evaluated in detail in the well-dierentiated and dedierentiated

tumor components.

Result: We could identify several pathogenic mutations, as well as signi-

cantly deregulated miRNAs, inuencing components of the BMP/TGF- β

signaling, e.g. BMPR2, TGFBR2 and SMADs.

Discussion: So far, the underlying mechanisms of the development of

DDCS is widely unknown. Our results indicate an involvement of the

BMP/TGF-β signaling in the dedierentiation.

Conclusion: In this study, we combined the analyses of the mutation pro-

le and the dierential miRNA expression in the dierent DDCS compo-

nents. e revealed dierences between the both components could be a

new hint for the underlying mechanisms of the dedierentiation process

of conventional chondrosarcoma.

Reference:

1 FS Karras et al., Comparative Analysis of miRNA Expression in Dedierentiated

and Well-Dierentiated Components of Dedierentiated Chondrosarcoma,

Pathol Res Pract (2023) 154414. https://doi.org/10.1016/j.prp.2023.154414.

Disclosure Statement: e authors declare no conict of interest.

888

Implementation of a Molecular Tumor Board (MTB) – One-year

Experience

Lena Häberle1; Simon Labuhn2; Martin Schlensog1; Wolfgang Göring1;

Karl-Ludwig Schäfer1; Kai Horny3; Silke Redler4; Tilman Rau1;

Wolfram T Knoefel5; Arndt Borkhardt6; Irene Esposito1

1Heinrich Heine University & University Hospital Duesseldorf, Institute of

Pathology, Duesseldorf, Deutschland

2Heinrich Heine University & University Hospital Duesseldorf, Department

of Gastroenterology, Hepatology and Infectious Diseases, Duesseldorf,

Deutschland

3Heinrich Heine University & University Hospital Duesseldorf, Institute of

Medical Biometry and Bioinformatics, Duesseldorf, Deutschland

4Heinrich Heine University & University Hospital Duesseldorf, Institute of

Human Genetics, Duesseldorf, Deutschland

5Heinrich Heine University & University Hospital Duesseldorf, Department of

General, Visceral and Thoracic Surgery, Duesseldorf, Deutschland

6Heinrich Heine University & University Hospital Duesseldorf, Department of

Paediatric Oncology, Haematology and Immunology, Duesseldorf, Deutschland

Background: Molecular tumor boards (MTBs) have become a pivotal

platform to translate results from molecular analyses into patient care.

e goal of the MTB panel consisting of oncologists, pathologists, human

geneticists, bioinformaticians and other experts is to facilitate an indi-

vidualized therapy recommendation for each patient based on molecular

data and considering the clinical situation.

Methods: Aer implementation of a local MTB at the University Hospital

of Duesseldorf (UKD) in July 2022, MTB data were collected systemati-

cally and evaluated aer one year.

Result: Patient numbers increased almost 4-fold comparing the rst

6 months with the last 6 months of operation. Human genetic analysis

results were available in 8% of cases. In 11%, human genetic counseling

and diagnostics were recommended. erapy recommendations were

made in almost 2/3 of MTB cases. Recommendations were based on

small variants in 42%, fusions in 5%, and other markers (e.g., microsat-

ellite instability, Her2/neu positivity) in 53%. erapy studies were rec-

ommended in 24%, while o-label therapies were recommended in 30%.

EMA-approved targeted therapies were available in 10%. MTB recom-

mendations were implemented in 34% of cases. Non-adherence to MTB

recommendations was mainly due to (a) still available and eective stand-

ard therapy options (38%), and (b) death or deterioration of the patient’s

general condition within 4 weeks of the MTB (30%).

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts140

Discussion: MTBs are useful to pool interdisciplinary resources and create

individual therapy recommendations. While recommendations are feasi-

ble for the majority of MTB cases, the actual realization of therapy options

may be challenging. e optimal time point for the MTB presentation

seems to be crucial for the implementation of therapy recommendations.

Conclusion: Systematic data collection and analysis from MTBs are

needed to improve MTB eectiveness. Importantly, follow-up informa-

tion on therapy response will be inquired to assess patients’ benet from

MTB inclusion.

Disclosure Statement: e authors declare no conict of interest.

926

Targeting metabolic pathways important for human cancer

cells with an ultramutator phenotype

Gleice Borges1,2; Isabell Vetterlein2; Mona Reichel1,2; Mara Sannai2;

Philipp Koch2; Torsten Kroll2; Ilkka Miinalainen3; Berit Jungnickel1;

Helmut Pospiech2,4

1Friedrich-Schiller-Universität Jena, Jena, Deutschland

2Leibniz-Institut für Alternsforschung - Fritz-Lipmann-Institut Jena, Jena,

Deutschland

3University of Oulu, Oulu, Finnland

4Forschungslabore der Klinik für Frauenheilkunde und Geburtshilfe,

Universitätsklinikum Düsseldorf, Life Science Center, Düsseldorf, Deutschland

Background: Pathogenic variants POLE that encodes for the catalytic

subunit of DNA polymerase (Pol) ε have been associated with ultramu-

tated cancers. Genetic alterations underlying this phenotype target the

proofreading exonuclease of Pol ε. We study the eects of Pol ε exonu-

clease defects on the function of a model cancer cell line. ereby, we aim

to identify and characterize genes involved in metabolic pathways, whose

loss is detrimental for the survival of ultramutated cancer cells.

Methods: We performed a genome-wide knock-out screen of a nearly

haploid human HAP1 cancer cell model decient in Pol ε proofread-

ing followed by validation using siRNA knock-downs in order to iden-

tify potential synthetic lethal genes and underlying pathways relevant

for ultramutated cells. Selected targets were characterized by Western

blots, metabolic analysis and clonogenic survival aer pharmacological

intervention.

Results: We identied genes whose inactivation reduces proliferation and

viability in Pol ε proofreading-decient, but not in parental cells wild type

(WT) for Pol ε. Enrichment analysis of the identied hits suggests that loss

of genes involved in transcription, RNA/protein metabolism and trans-

port, mitochondrial translation, cell adhesion/cytoskeleton would reduce

the survival of ultramutated cells compared to WT cells.

Conclusion: Our analysis identied energy and protein homeostasis as

processes particularly important for ultramutated cells that provide new

potential targets for the treatment of ultramutated cancers.

Disclosure Statement: e authors declare no conict of interest.

Novel Therapeutics: Clinical Trials

445

Bewertung des Nutzens von NEPA (xe Kombination von

Netupitant/Palonosetron) zur Vorbeugung von durch

Chemotherapie ausgelöster Übelkeit und Erbrechen (CINV)

bei Patienten mit erhöhtem Emesisrisiko, die eine moderat

emetogene Chemotherapie erhalten

Meinolf Karthaus1,2; Daniel Christoph3; Michael Patrick Lux4;

Ralf-Dieter Hofheinz5; Karin Jordan6

1Klinikum Neuperlach, München, Deutschland

2München Klinik Neuperlach, München, Deutschland

3Evang Klinikum Essen, Essen, Deutschland

4Klinik für Gynäkologie und Geburtshilfe, Frauenklinik St. Louise, Paderborn,

Deutschland

5Mannheim Cancer Center, Mannheim, Deutschland

6Department for Haematology, Oncology and Palliative Care, Potsdam,

Deutschland

Background: In patients receiving moderately emetogenic chemotherapy

(MEC), antiemetic guidelines lack evidence to recommend an NK1 recep-

tor antagonist (RA) for all patients; therefore, they endorse a 5-HT3 RA

+ dexamethasone (DEX). However, the NCCN guidelines recognize that

this approach oen results in inadequate prophylaxis and include an NK1

RA-containing option for patients with individual emetic risk factors (e.g.,

prior CINV, age <50, female). Evidence present that NEPA (a xed com-

bination of an NK1 RA, (fos)netupitant, and a 5-HT3 RA, palonosetron) is

eective in a pragmatic multi-center study (Zelek 2021) in a heterogene-

ous population of patients with cancer receiving anthracycline/cyclophos-

phamide (AC) or MEC and in patients with CINV risk factors.

Trial Design: is is a Phase IV, randomized, open-label, multicenter,

multinational study conducted in 7 countries (NCT04817189). An algo-

rithm incorporating 7 predictive risk factors (adapted from Dranitsaris

2017) is used to select patients at increased risk of CINV. Suitable patients

≥18 years, naïve or non-naive to chemotherapy, with a diagnosis of any

cancer scheduled to receive 3 consecutive cycles of an intravenous MEC

regimen, are randomized to either NEPA + DEX or the 5-HT3 RA + DEX

standard of care. A single dose of oral NEPA + 8 mg DEX or a 5-HT3 RA

+ DEX is administered on day 1.

e Multinational Association of Supportive Care in Cancer (MASCC)

Antiemesis Tool (MAT) is used to capture nausea and vomiting

post-chemotherapy. e primary endpoint is complete response (CR: no

emesis, no rescue use) during the overall (0-120 h) phase post-chemother-

apy over 3 cycles. A generalized linear model will analyze CR over 3 cycles

of MEC with logit link function, binomial distribution, and with study

treatment, carboplatin use, and the country as factors.

A total of 530 patients are planned (265/group) worldwide. Enrolment

is open; as of August 10, 2023, 349 patients have been randomized. In

Germany, the recruitment is closed with 96 patients that have been

enrolled by ve study centers.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 141

811

TIGER PRO-Active: patient-reported neurocognitive

functioning and app-based assessment of daily activity and

sleep in glioblastoma patients treated with TTFields therapy

Martin Glas1,2; Ghazaleh Tabatabai3; Rainer Fietkau4;

Roland Goldbrunner5; Oliver Bähr6

1Universitätsklinikum Essen, Klinik für Neurologie, Abteilung für Klinische

Neuroonkologie, Essen, Deutschland

2Universitätsklinikum Essen, West German Cancer Center (WTZ) and German

Cancer Consortium Partner Site, Essen, Deutschland

3Universitätsklinikum Tübingen, Department of Neurology and Interdisciplinary

Neurooncology, Tübingen, Deutschland

4Universitätsklinikum Erlangen, Department of Radiation Oncology, Erlangen,

Deutschland

5Universitätsklinikum Köln, Zentrum für Neurochirurgie, Köln, Deutschland

6Hospital Aschaenburg-Alzenau, Clinic of Neurology, Aschaenburg,

Deutschland

Background: TTFields therapy is approved for newly diagnosed glioblas-

toma (ndGBM), recommended by the DGN and DGHO guidelines, and a

service of the statutory health insurance funds. Additional real-world data

is warranted. TIGER study (NCT03258021) provides insight into patients’

therapy decisions, TTFields therapy duration and usage, health-related

quality-of-life (HRQoL), survival, and adverse events (AEs) in the real-

world clinical setting. We established the TIGER PROgram (collaborative

network of centers involved in the TIGER study including new centers in

Germany) to collect additional real-world evidence. TIGER PRO-Active

study (NCT04717739; rst study initiated within program) will inves-

tigate daily activity, sleep, and neurocognitive functioning in ndGBM

patients who were treated with TTFields therapy in routine clinical care

in Germany.

Study design e prospective, non-interventional, multicenter TIGER

PRO-Active study in Germany is the rst to assess disease course by

means of digitally-measured parameters. Approximately 500 adult

ndGBM patients will be recruited in accordance with the treatment

indication for TTFields therapy over a span of 2-years. Patient-reported

change from baseline scores in daily physical activity and sleep (using

smartphone-based apps) and neurocognitive functioning (using validated

Montreal Cognitive Assessment [MoCA] interview test) will be assessed.

HRQoL will be evaluated (using validated, patient-reported EORTC

QLQ-C30 and BN20 questionnaires). Employment status, therapy usage,

and serious AEs will be assessed. Data will be collected for ≥12 months.

Conclusion: TIGER PROgram will allow use of previously-established

administrative structures to conduct new real-world studies, enabling

use of a basic dataset across dierent trials and to facilitate meta-analy-

ses across dierent populations. TIGER PRO-Active study will provide

detailed insights into app-captured daily physical activity and sleep, and

neurocognitive functioning of ndGBM patients using TTFields therapy in

routine clinical care.

Disclosure Statement: e authors declare the following: Authors are

collaborators of Novocure

Novel Therapeutics: Targeted Therapies,

Immunotherapies, Cellular Therapies

Idecabtagene vicleucel (ide-cel) versus standard (std)

regimens in triple-class–exposed (TCE) relapsed and

refractory multiple myeloma (RRMM): KarMMa-3 subgroup

analysis in patients (pts) receiving bridging therapy

Hermann Einsele1; Paula Rodríguez-Otero2; Bertrand Arnulf3; Krina Patel4;

Salomon Manier5; Luciano J. Costa6; Nizar J Bahlis7; Annemiek Broijl8;

Christine Chen9; Ingerid Weum Abrahamsen10; Michel Delforge11;

Usama Gergis12; Marc S Raab13; Seema Singhal14; Rafat Abonour15;

Anna Truppel-Hartmann16; Rashmi Bhatnagar17; Jasper Felten18;

Andrea Caia18; Fan Wu18; Julia Piasecki18; Mark Cook19;

Sikander Ailawadhi20

1Universitätsklinikum Würzburg (UKW), Würzburg, Deutschland

2Clínica Universidad de Navarra, Pamplona, Spanien

3Hôpital Saint-Louis, APHP, Université Paris Cité, Paris, Frankreich

4MD Anderson Cancer Center, The University of Texas, Houston, USA

5Centre Hospitalier Universitaire de Lille, Université de Lille, Lille, Frankreich

6University of Alabama at Birmingham, Birmingham, USA

7Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, Canada

8Erasmus MC Cancer Institute, Rotterdam, Niederlande

9Princess Margaret Hospital, Toronto, Canada

10Oslo University Hospital, Oslo, Norwegen

11Universitaire Ziekenhuizen Leuven, Leuven, Belgien

12Thomas Jeerson University, Philadelphia, USA

13Universitätsklinikum Heidelberg, Heidelberg, Deutschland

14Robert H. Lurie Comprehensive Cancer Center of Northwestern University,

Chicago, USA

15Indiana University School of Medicine, Indianapolis, USA

162seventy bio, Cambridge, USA

17Syneos Health, Haryana, Indien

18Bristol Myers Squibb, Princeton, USA

19Celgene International Sarl, a Bristol-Myers Squibb Company, Boudry, Schweiz

20Mayo Clinic, Jacksonville, USA

Background: Ide-cel, a BCMA-directed CAR T cell treatment (Tx),

improved median progression-free survival (mPFS) and overall response

rates (ORR) vs std regimens in pts with TCE RRMM (KarMMa-3;

NCT03651128).

Methods: Ide-cel-randomized pts in KarMMa-3 could receive ≤ 1 cycle of

bridging Tx (BTx). Disease burden (DB) was based on measurable disease

pre-leukapheresis (LK; serum/urine M-protein, M-protein, or dierence

between involved/uninvolved free light chain). Pts were grouped based on

DB change from LK to ide-cel (≥ 25% increase [I]; ≥ 25% decrease [D];

no change [NC]). Ecacy (PFS, ORR, CRR, duration of response [DOR])

and safety were assessed.

Result: 213/254 ide-cel-randomized pts received BTx; 200 were evaluable

for change in DB pre-ide-cel (DPd, n = 45; DVd, n = 20; IRd, n = 25; Kd,

n = 26; EPd, n = 59; other, n = 25) (I, n = 59 [28%]; D, n = 32 [15%]; NC,

n = 109 [51%]). Median number of cycles for all BTx regimens was 1.

More pts with increased disease had baseline high-risk MM characteris-

tics (extramedullary plasmacytoma, I, 41%; D, 16%; NC, 24%; high-risk

cytogenetics, I, 53%; D, 25%; NC, 38%; triple-class–refractory disease, I,

90%; D, 63%; NC, 59%). mPFS (95% CI) was numerically longer in D vs

I/NC pts (I, 6.9 [2.4–11.8]; D, 20.7 [11.2–NR]; NC, 15.1 [12.4–17.3] mo).

ORR (95% CI) was numerically higher in D vs I/NC pts (I, 56% [43–69];

D, 97% [91–100]; NC, 80% [72–87]), with deeper (CRR: I, 32%; D, 56%;

NC, 39%), more durable (mDOR [95% CI]: I, 9.3 [7.5–17.3]; D, 18.6 [8.6–

NR]; NC, 13.4 [10.9–21.4] mo) responses. Any-grade (G; I, 90%; D, 97%;

NC, 96%) and G3/4 adverse event (AE; I, 81%; D, 84%; NC, 95%) inci-

dence was similar. G5/serious AEs occurred in 15%/42% (I), 6%/25% (D)

and 13%/44% (NC); any-G cytokine release syndrome in 80% (I), 94%

(D), and 84% (NC); G3/4 in 7%, 3%, and 4%; any-G investigator-identi-

ed neurotoxicity in 24% (I), 3% (D), and 13% (NC); G3/4 in 3%, 0%, and

4%, respectively.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts142

Discussion: Ide-cel lead to longer mPFS and greater response in pts with

TCE RRMM who had D/NC vs I in DB with BTx.

Conclusion: Ide-cel prolongs mPFS with consistent safety.

First presented: IMS 2023 Annual Congress.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

237

Idecabtagene vicleucel (ide-cel) versus standard regimens in

patients (pts) with triple-class–exposed (TCE) relapsed and

refractory multiple myeloma (RRMM): a KarMMa-3 analysis in

the modied intent-to-treat (mITT) population

Christoph Scheid1; Salomon Manier2; Sikander Ailawadhi3;

Paula Rodríguez-Otero4; Bertrand Arnulf5; Krina Patel6; Scott R. Solomon7;

Rachid Baz8; Sundar Jagannath9; Noopur Raje10; Maria-Victoria Mateos11;

Al-Ola Abdallah12; Hermann Einsele13; Sergio Giralt14; Thomas Pabst15;

Aurore Perrot16; Yi Lin17; Anna Truppel-Hartmann18; Rashmi Bhatnagar19;

Jasper Felten20; Andrea Caia20; Julia Piasecki20; Mark Cook21;

Philippe Moreau22

1University Hospital of Cologne, Cologne, Deutschland

2Centre Hospitalier Universitaire de Lille, Université de Lille, Lille, Frankreich

3Mayo Clinic Florida, Jacksonville, USA

4Clínica Universidad de Navarra, Pamplona, Spanien

5Hôpital Saint-Louis, Assistance Publique–Hôpitaux de Paris, Université Paris

Cité, Paris, Frankreich

6MD Anderson Cancer Center, The University of Texas, Houston, USA

7Northside Hospital Cancer Institute, Atlanta, USA

8H. Lee Mott Cancer Center, Tampa, USA

9Mount Sinai Medical Center, New York, USA

10Massachusetts General Hospital, Boston, USA

11Hospital Clínico Universitario de Salamanca, Salamanca, Spanien

12University of Kansas Cancer Center, Kansas City, USA

13University Hospital Würzburg, Würzburg, Deutschland

14Memorial Sloan Kettering Cancer Center, New York, USA

15University Hospital Inselspital and University of Bern, Bern, Schweiz

16Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, Frankreich

17Mayo Clinic, Rochester, USA

182seventy bio, Cambridge, USA

19Syneos Health, Haryana, Indien

20Bristol Myers Squibb, Princeton, USA

21Celgene International Sarl, a Bristol-Myers Squibb Company, Boudry, Schweiz

22University Hospital Hôtel-Dieu, Nantes, Frankreich

Background: With combination regimens use, including immuno-

modulatory agents, proteasome inhibitors, and daratumumab, pts with

RRMM become TCE earlier in their treatment (Tx). In KarMMa-3

(NCT03651128), ide-cel signicantly improved median progression-free

survival (mPFS) and overall response rates (ORR) versus standard (std)

regimens in pts with TCE RRMM (Rodríguez-Otero P et al, NEJM 2023).

Ecacy was analyzed in the KarMMa-3 ITT population (pop). We report

outcomes in the mITT pop who received the study Tx.

Methods: Pts with RRMM who received 2–4 prior lines of Tx, were TCE,

and had disease refractory to the last regimen, were randomized 2:1 to

receive ide-cel or a std regimen (DPd, DVd, IRd, Kd or EPd). PFS, ORR,

and safety were assessed in the mITT pop.

Result: Of the 386 pts in the ITT pop, 351 received study Tx and con-

stituted the mITT pop (225 pts, ide-cel; 126 pts, std regimens). Baseline

characteristics were balanced between Tx arms, and comparable to the

ITT pop. Tx with ide-cel led to longer PFS vs std regimens (mPFS [95%

CI], 14.5 [12.2−17.3] vs 4.4 [3.4−5.9] mo; HR 0.43; 95% CI, 0.33−0.56).

ORR was higher with ide-cel vs std regimens (80% vs 44%), with higher

rates of deep response (≥ complete response: 44% vs 6%). Grade (G) 3/4

AEs occurred in 213/225 (95%) and 94/126 (75%) pts in the ide-cel and

std regimens arms, respectively; most commonly neutropenia (80% vs

40%), anemia (51% vs 18%), and thrombocytopenia (44% vs 17%). G 5

AEs occurred in 12% and 6% of pts, of which 5% and 2%, respectively,

were due to disease progression.

Discussion: Only 35 randomized pts in the ITT pop did not receive ide-

cel (n = 29) or std regimens (n = 6). A greater proportion of pts who did

not receive ide-cel had high-risk features vs the mITT pop (R-ISS stage III

[38% vs 9%] and higher tumor burden [52% vs 25%]). Compared with the

ITT pop, mPFS for ide-cel was longer in the mITT pop while mPFS for

std regimens remained the same, reecting ide-cel ecacy in infused pts.

Conclusion: In the mITT pop, the benet of ide-cel over std regimens was

consistent with that observed in the ITT pop.

First presented: IMS 2023 Annual Congress.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

262

TRANSCEND FL: phase 2 study results of lisocabtagene

maraleucel (liso-cel) in patients (pts) with relapsed/refractory

(R/R) follicular lymphoma (FL)

Peter Borchmann1,2; Franck Morschhauser3; Saurabh Dahiya4; M. Lia

Palomba5; Alejandro Martín García-Sancho6; Juan Luis Reguera Ortega7;

John Kuruvilla8; Ulrich Jäger9; Guillaume Cartron10; Koji Izutsu11;

Martin Dreyling12; Brad Kahl13; Hervé Ghesquieres14; Kirit Ardeshna15;

Hideki Goto16; Anna Maria Barbui17; Jeremy S. Abramson18;

Isabelle Fleury19; Stephan Mielke20; Thalia Farazi21; Omotayo Fasan22;

James Lymp23; Min Vedal23; Rina Nishii22; Ariel Avilion23; Jessica Papuga24;

Loretta J. Nastoupil25

1Universität zu Köln, Köln, Deutschland

2Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD),

Cologne, Deutschland

3Centre Hospitalier Universitaire de Lille, Lille, Frankreich

4Stanford University School of Medicine, Stanford, USA

5Memorial Sloan-Kettering Cancer Center, New York, USA

6Hospital Universitario de Salamanca, IBSAL, CIBERONC, Centro de Investigación

del Cáncer-IBMCC (USAL-CSIC), Salamanca, Spanien

7Virgen del Rocío University Hospital, Sevilla, Spanien

8Princess Margaret Cancer Centre, Toronto, Kanada

9Medizinische Universität Wien, Wien, Österreich

10Universität Montpellier, Montpellier, Frankreich

11National Cancer Center Hospital, Tokyo, Japan

12Medizinische Klinik III, Klinikum der Universität, LMU München, Munich,

Deutschland

13Washington University School of Medicine in St. Louis, St. Louis, USA

14Hôpital Lyon Sud, Lyon, Frankreich

1514University College London Hospitals NHS Foundation Trust - University

College Hospital, London, United Kingdom

16Hokkaido University Hospital, Sapporo, Japan

17Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italien

18Massachusetts General Hospital Cancer Center, Boston, USA

19Maisonneuve-Rosemont Hospital, Montréal, Kanada

20Karolinska Institutet and University Hospital, Karolinska Comprehensive

Cancer Center, Stockholm, Schweden

21Bristol Myers Squibb, San Francisco, USA

22Bristol Myers Squibb, Princeton, USA

23Bristol Myers Squibb, Seattle, USA

24Celgene International Sàrl, a Bristol-Myers Squibb Company, Boudry, Schweiz

25The University of Texas MD Anderson Cancer Center, Houston, USA

Background: TRANSCEND FL (NCT04245839), a phase 2, single-arm,

multicohort, pivotal study, assessed ecacy/safety of liso-cel (anti-CD19

CAR T cell therapy) in pts with R/R indolent NHL (iNHL).

Methods: Pts with R/R FL were third-line or later (3L+) and 2L pts with

disease progression within 24 mo (POD24 and mGELF). Pts received ≥

1 prior combination systemic therapy (incl. an anti-CD20 antibody and

alkylator); and liso-cel (100 × 106 CAR+ T cells) aer lymphodepleting

chemotherapy. Bridging therapy was allowed. Primary/secondary end-

points: ORR per independent review committee by PET/CT; CR rate,

duration of response (DOR), PFS, OS, safety.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 143

Result: At cuto (Jan 27, 2023), 130/139 (94%) leukapheresed pts received

liso-cel, 5 received nonconforming product, and 124 (89%) were ecacy

evaluable (EE). In 3L+ FL pts: median (range) age was 62 y (23–80);

89% had Ann Arbor stage III/IV disease; high risk FLIPI, 57%. 43%

had POD24, 53% met GELF criteria, and 64% were double refractory to

anti-CD20 antibody and alkylator. Median (range) prior lines of therapy

was 3 (2–10). Median (range) follow-up was 18.9 mo (0.3–28.2). In 3L+

FL EE pts (n = 101), the primary endpoint was met at ORR 97.0% (95%

CI, 91.6–99.4; one-sided P < 0.0001). CR rate was 94.1% (95% CI, 87.5–

97.8; one-sided P < 0.0001). Median DOR/PFS were not reached (median

follow-up: 16.6 mo/17.5 mo); 12-mo DOR/PFS were 81.9%/80.7%.

Results were similar in 2L+ FL EE pts. In the safety set (2L+ FL, n=130),

most common grade (G) ≥ 3 treatment-emergent adverse events (TEAEs)

were cytopenias; most frequently neutropenia (65%). One TEAE death

occurred (G5 macrophage activation syndrome). Cytokine release syn-

drome (CRS) occurred in 58% (G3, 1%; no G4–5) and neurological events

(NE) in 15% (G3, 2%; no G4–5). Prolonged cytopenia (G≥ 3 laboratory

values at day 29) occurred in 22% and G≥ 3 infection in 5%.

Discussion: Liso-cel provided high, durable response with low G≥ 3

TEAE rates.

Conclusion: In pts with R/R FL, liso-cel showed clinically meaningful

benet and favorable safety.

First published: Morschhauser F et al. Hematol Oncol 2023;41[S2]:LBA4.

Disclosure Statement: e authors declare that there are conicts of interest.

econicts were submitted to the congress organizer KUKM GmbH and KUKM

can disclose them if needed.

267

Novel MACC1 transcriptional inhibitors for anti-metastatic

personalized therapy for high risk patients

Paul Curtis Schöpe1; Shixian Yan1; Joe Lewis2; Kerstin Putzker2;

Ulrike Uhrig2; Specker Edgar3; Von Kries Jens Peter3; Mathias Dahlmann1,4;

Janice Smith1; Hector E Sanchez-Ibarra1; Unger Anke5;

Mia-Lisa Zischinsky5; Bert Klebl5; Wolfgang Walther1,4; Anahid Omran3;

Marc Nazaré3; Dennis Kobelt1,4; Ulrike Stein1,4

1Experimental and Clinical Research Center, Charité – Universitätsmedizin

Berlin, and Max-Delbrück-Center for Molecular Medicine, Berlin, Deutschland

2The European Molecular Biology Laboratory, EMBL, Heidelberg, Deutschland

3Leibniz-Forschungsinstitut für Molekulare Pharmakologie, FMP, Berlin,

Deutschland

4German Cancer Consortium (DKTK Partnersite Berlin), Deutsches

Krebsforschungszentrum (DKFZ), Heidelberg, Deutschland

5Lead Discovery Center, LDC, Dortmund, Deutschland

Background: Metastasis formation is the leading cause of death in

colorectal cancer, oen caused by insucient therapies. Compounds

able to interfere with metastasis formation are desperately needed. In this

study, novel small molecules were identied and characterized which tar-

get the expression of MACC1 (Metastasis Associated in Colon Cancer 1).

MACC1 has been established as a key molecule for tumor progression and

metastasis formation in colorectal cancer (CRC) and more than 20 solid

tumor entities.

Methods: A high-throughput screen was conducted at the EMBL,

Heidelberg using a MACC1 promoter luciferase construct transfected into

HCT116 cells. All compounds were evaluated for their inhibition on tran-

scription by quantitative RT-PCR (qRT-PCR) and Western Blots in CRC

and other entity cell lines. Cell motility was evaluated using wound heal-

ing and Boyden chamber assay. In vivo experiments were conducted using

a HCT116 CDX tumor model. Characteristics were evaluated by ADMET

studies at the LDC GmbH. RNA-sequencing and analysis explored the

mode of action of these novel compounds.

Result: Tetrazolo-pyridazine-harboring Compound 22 and analogues

were identied as promising transcriptional inhibitors of MACC1.

ese compounds eectively inhibit MACC1 gene expression lead-

ing to a reduction of cell motility in vitro in CRC and cross entity cell

lines. Furthermore, they inhibit MACC1-induced tumor progression and

metastasis in vivo. Our ADMET studies conrmed drug-likeness of the

compounds with high stability in human plasma and great permeabil-

ity. RNA-sequencing revealed an immune pathway which is likely to be

altered by the compounds.

Discussion: We demonstrated that our novel compounds are eective

transcriptional inhibitors of MACC1. Further, they restrict MACC1

driven cell motility in vitro and tumor progression and metastasis for-

mation in vivo. ADMET studies conrm drug-likeness and favorable

characteristics.

Conclusion: Taken together, this novel class of small molecules represents

promising candidates for personalized anti-metastatic therapy.

Disclosure Statement: e authors declare no conict of interest.

297

The Ligase IV Inhibitor SCR130 has Limited Radiosensitizing

Potential in Head and Neck Cancer Cell Lines

Laura S. Hildebrand; Rainer Fietkau; Luitpold Distel

Universitätsklinikum Erlangen, Strahlenklinik, Erlangen, Deutschland

Background: Radiation sensitivity could be improved by small molecule

inhibitors that interfere with DNA double-strand break repair (DDBR).

We inhibited (Ligase IV inhibitor SCR130) one of the main DDBR mech-

anisms Non-homologous end joining because it is oen the only unmu-

tated DDBR possibility in tumor cells. Healthy cells instead have the

advantage of other available DDBR pathways.

Methods: HNSCC cell lines and healthy broblasts were treated 48 h

with 30 µM SCR130 and where required additionally with a single dose

of 2 Gy 3 h aerwards. Dividing cells were determined by the colony for-

mation assay. Cell death (apoptosis: Annexin V, necrosis: 7-AAD) and

cell cycle distribution (Hoechst) were measured with ow cytometry.

Immunostaining was used to investigate the quantity of γH2AX, Ki67 and

Ligase IV in the cells.

Result: e surviving fraction in the colony formation assay decreased in

only 2 of 7 HNSCC cell lines signicantly in the combined treatment (30

µM SCR130 + 2 Gy) compared to irradiation (2 Gy). In 4 of 7 HNSCC

cell lines the combined treatment resulted in a signicant increase of dead

cells compared to irradiation (e.g. UD-SCC-2 from 27 % to 87 %). e

number of cells in G0/G1 phase was increased signicantly by the com-

bination compared to irradiation in 4 of 7 HNSCC cell lines, whereas it

decreased in broblasts. e correlation of Ligase IV in the cell and the

surviving fraction suggested that more Ligase IV in untreated cells results

in a stronger reaction to the combined treatment.

Discussion: e Ligase IV Inhibitor SCR130 leads to increased radiation

sensitivity in some HNSCC cell lines and inuences their cell cycle dis-

tribution even if the eects especially regarding clonogenicity are slight.

Further experiments are necessary to determine cell cycle checkpoints,

cell line specic dierences and escape mechanisms.

Conclusion: e Ligase IV inhibitor SCR130 has limited radiosensitizing

potential in HNSCC cell lines which is surprising considering the vital

role of Ligase IV in DDBR.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts144

334

Idecabtagene vicleucel (ide-cel) vs standard regimens in

patients (pts) with triple-class-exposed (TCE) relapsed and

refractory multiple myeloma (RRMM): a KarMMa-3 analysis in

high-risk subgroups

Marc S Raab1; Krina Patel2; Paula Rodríguez-Otero3; Salomon Manier4;

Rachid Baz5; Michele Cavo6; Natalie Callander7; Luciano J. Costa8;

Philippe Moreau9; Scott R. Solomon10; Christine Chen11; Noopur Raje12;

Christoph Scheid13; Michel Delforge14; Jeremy Larsen15; Thomas Pabst16;

Kenshi Suzuki17; Anna Truppel-Hartmann18; Julia Piasecki19;

Jasper Felten19; Andrea Caia19; Mark Cook19,20; Sergio Giralt21;

Maria-Victoria Mateos22

1Universitätsklinikum Heidelberg, Heidelberg, Deutschland

2MD Anderson Cancer Center, The University of Texas, Houston, USA

3Clinica Universidad de Navarra, Pamplona, Spanien

4Centre Hospitalier Universitaire de Lille, Université de Lille, Lille, Frankreich

5Mott Cancer Center, Tampa, FL, USA

6IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of

Hematology and the Department of Experimental, Diagnostic, and Specialty

Medicine, Bologna University School of Medicine, Bologna, Italien

7University of Wisconsin Carbone Cancer Center, Madison, USA

8University of Alabama at Birmingham, Birmingham, USA

9University Hospital of Nantes, Nantes, Frankreich

10Northside Hospital Cancer Institute, Atlanta, USA

11Princess Margaret Hospital, Toronto, Kanada

12Massachusetts General Hospital, Boston, USA

13Uniklinik Köln, Köln, Deutschland

14Universitaire Ziekenhuizen, Leuven, Belgien

15Mayo Clinic Arizona, Phoenix, USA

16University Hospital Inselspital and University of Bern, Bern, Schweiz

17Japanese Red Cross Medical Center, Tokyo, Japan

182seventy bio, Cambridge, MA, USA

19Bristol Myers Squibb, Princeton, USA

20Institute of Cancer and Genomic Sciences, University of Birmingham,

Birmingham, United Kingdom

21Memorial Sloan Kettering Cancer Center, New York, USA

22Hospital Clínico Universitario de Salamanca, Salamanca, Spanien

Background: Ide-cel improved median progression-free survival (mPFS)

and overall response rates (ORRs) vs standard (std) regimens in pts with

TCE RRMM in KarMMa-3 (NCT03651128). Here we show the ecacy of

ide-cel vs std regimens in pts with high-risk (HR) disease in KarMMa-3.

Methods: In KarMMa-3, pts with RRMM with 2–4 prior regimens, TCE

disease, and refractoriness to the last regimen were randomized 2:1

to receive ide-cel or a std regimen. Ecacy (PFS, ORR, and complete

response rate [CRR]) was assessed in HR groups including pts with cyto-

genetic abnormalities, R-ISS stage III disease, high tumor burden, extra-

medullary plasmacytomas (EMPs), and triple-class refractory (TCR)

disease.

Result: Baseline demographics and HR disease characteristics were bal-

anced between treatment arms. Median time to progression on the last

prior regimen was short in pts treated with both ide-cel vs std regimens in

all HR subgroups: cytogenetic abnormalities (5.6 vs 6.7 mo), R-ISS stage

III disease (3.9 vs 3.5 mo), high tumor burden (5.1 vs 6.2 mo), EMP (5.1

vs 5.1 mo), and TCR disease (5.6 vs 5.8 mo).

At a median follow-up of 18.6 (0.4–35.4) mo, mPFS was longer in pts

treated with ide-cel vs std regimens in all HR subgroups: cytogenetic

abnormalities (11.9 vs 4.2 mo), R-ISS stage III disease (5.2 vs 3.0 mo),

high tumor burden (11.0 vs 4.9 mo), EMP (7.2 vs 2.0 mo), and TCR dis-

ease (11.2 vs 3.5 mo). ORRs were improved with ide-cel vs std regimens,

regardless of the presence of HR disease. Similarly, CRRs were improved

in pts treated with ide-cel vs std regimens in all HR subgroups: cytoge-

netic abnormalities (31.8 vs 4.9%), R-ISS stage III (16.1 vs 7.1%), high

tumor burden (31.0 vs 8.8%), EMP (23.0 vs 3.1%), and TCR disease (33.5

vs 1.1%).

Discussion: Pts treated with ide-cel had lower risk of disease progression

or death and higher odds of achieving an overall response (with higher

CRRs) compared with pts who received std regimens, regardless of base-

line HR disease.

Conclusion: ese results support use of ide-cel in pts with TCE RRMM,

including pts with HR disease.

First published: Patel K et al. HemaSphere 2023;7[S3]:S195.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

358

ARTIC -Abscopal eects in metastasized cancer patients

treated withradiotherapy andimmunecheckpoint inhibition-

Preliminary results of a large observational multicenter study

of the young DEGRO

Maike Trommer1,2,3; Alexander Rühle4,5; Allison Lamrani6;

Charlotte Schmitter6; Justus Kaufmann7; Matthias Mäurer8,9;

Georg Wurschi8,10; Ping Jiang11; Felix Ehret12; Andrea Baehr13;

Annika Hardt14; Raphael Bodensohn15,16; Lukas Käsmann15;

Danny Jazmati17; Sebastian Neppl1; Anna Hagemeier18; Simone Wegen1

1Department of Radiation Oncology, Cyberknife and Radiotherapy, Faculty of

Medicine and University Hospital Cologne, Cologne, Deutschland

2Department of Radiation Oncology, Olivia Newton-John Cancer Wellness &

Research Centre, Austin Health, Melbourne, Australien

3Center for Molecular Medicine Cologne (CMMC), Cologne, Deutschland

4Department of Radiation Oncology, Medical Center – University of Freiburg,

Faculty of Medicine, University of Freiburg, Freiburg, Deutschland

5Department of Radiation Oncology, University of Leipzig, Leipzig, Deutschland

6University Hospital Erlangen, Department of Radiation Oncology, Erlangen,

Deutschland

7Department of Radiation Oncology, University Medical Center of the Johannes

Gutenberg University, Mainz, Deutschland

8Department of Radiation Oncology, University Hospital Jena, Jena,

Deutschland

9Clinician Scientist Programm OrganAge, University Hospital Jena, Jena,

Deutschland

10Clinician Scientist Program, IZKF, Jena University Hospital, Jena, Deutschland

11Department of Radiation Oncology and Radiotherapy, Pius Hospital

Oldenburg, University Medicine Oldenburg, Oldenburg, Deutschland

12Department of Radiation Oncology, Charité - Universitätsmedizin Berlin,

corporate member of Freie Universität Berlin and Humboldt Universität zu

Berlin, Berlin, Deutschland

13Department of Radiation Oncology, Medical Hospital Hamburg-Eppendorf,

Hamburg, Deutschland

14Outpatient Center of the University Medical Hospital Hamburg-Eppendorf,

Department of Radiotherapy and Radiation Oncology, Hamburg, Deutschland

15Department of Radiation Oncology, University Hospital, LMU Munich, Munich,

Deutschland

16Department of Radiation Oncology, University Hospital Tübingen, Tübingen,

Deutschland

17Department of Radiation Oncology, University Hospital Dusseldorf, Medical

Faculty, Heinrich-Heine-University Dusseldorf, Dusseldorf, Deutschland

18Institute of Medical Statistics and Computational Biology, Medical Faculty,

University of Cologne, University Hospital Cologne, Cologne, Deutschland

Background: Abscopal eects (AbE) are characterized by regression of

non-irradiated lesions (NIL) following radiotherapy (RT). eir induc-

tion is of interest for patients with progressive disease (PD) during

immune checkpoint inhibition (ICI), as AbE are likely immune-mediated.

e actual incidence in the RT-ICI setting is unclear.

Methods: Records were screened for patients receiving RT for PD of

metastatic cancer during ICI between 2015-21. Eligible patients had ≥1

NIL outside the 10% RT isodose. Patients switching systemic treatment

within radiological response assessment (RA) were excluded. Up to 5 NIL

were measured. Size reduction ≥30% was rated abscopal response (AR),

increase by ≥20% abscopal progression (AP). Sample size calculation was

based on an assumed AbE rate of 20% and required inclusion of 62 cases

with 10% precision (CI10-30%).

Result: We analyzed preliminary data from 8 participating centers.

3381 cases were screened to identify 98 eligible patients. Median

FU was 12 months. Lung cancer (n=32, 33%) and melanoma (n=30,

31%) were most frequent cancer types, nivolumab (n=48, 49%) most

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 145

frequent ICI, and hypofractionated (n=55, 56%) the most frequent

RT type. At final RA within 6 months, 59 (60%) patients showed

response to RT-ICI. 170 NIL from 95 patients could be included for

AbE assessment: 47 NIL (28%) showed AR, 96 (56%) were stable, 27

(16%) showed AP. On patient level, 34 (36%) had ≥1NIL with AR and

14 (15%) had AR of all NIL.

Discussion: is is the rst analysis of AbE following concurrent RT for

PD during ICI treatment in a large multicenter cohort. Our results are in

line with case series reporting 18-52% AR. Strengths of this study include

the multicentric design and meaningful sample size. Subgroup analyses,

predictors of AbE and survival outcomes are underway.

Conclusion: RT during ICI induced AbE in one third of progressing or

stable lesions outside the RT eld. More than half of the patients showed

response to treatment while 15% had response in all NIL. Our data sug-

gest synergy between RT and ICI and serve as reference for designing pro-

spective trials evaluating AbE.

Disclosure Statement: e authors declare no conict of interest.

418

Cost-eectiveness analysis of transplant-ineligible relapsed/

refractory diuse large B cell lymphoma interventions:

Results from the German eciency frontier approach

Melina Sophie Kurte1,2; Ann-Cathrine Siefen2; Florian Jakobs3; Bastian von

Tresckow4; Christian Reinhardt3; Florian Kron2,5,6,7

1Faculty of Medicine, University of Duisburg-Essen, Essen, Deutschland

2VITIS Healthcare Group, Cologne, Deutschland

3Department of Haematology and Stem Cell Transplantation, Faculty of

Medicine and University Hospital Essen, University of Duisburg-Essen, Essen,

Deutschland

4Department of Haematology and Stem Cell Transplantation, West German

Cancer Center and German Cancer consortium (DKTK partner site Essen),

University Hospital Essen, University of Duisburg-Essen, Essen, Deutschland

5Department I of Internal Medicine, Faculty of Medicine and University Hospital

Cologne, University of Cologne, Cologne, Deutschland

6Center for Integrated Oncology (CIO ABCD), Faculty of Medicine and University

Hospital of Cologne, University of Cologne, Cologne, Deutschland

7FOM University of Applied Sciences for Economics and Management, Essen,

Deutschland

Background: Recently, treatment of transplant-ineligible relapsed/refrac-

tory (r/r) diuse large B cell lymphoma (DLBCL) changed remarkably.

Since 2018, the European Medicines Agency has approved CAR-T thera-

pies (axicabtagene ciloleucel [axi-cel], lisocabtagene maraleucel [liso-cel],

tisagenlecleucel [tisa-cel]), and targeted therapies (polatuzumab-benda-

mustine-rituximab [pola-BR], tafasitamab-lenalidomide [Tafa-L]). In

Germany, innovative drugs are priced according to their additional benet

contrasted to current standard-of-care. To compare the cost-eectiveness

ratios of third-line and beyond (3+L) interventions for transplant-ineligi-

ble r/r DLBCL, an eciency frontier (EF) analysis was conducted from a

healthcare payer perspective.

Methods: Following the methods of the German Institute for Quality

and Efficiency in Healthcare (IQWiG), a systematic literature review

was performed to assess clinical benefit based on median overall sur-

vival (mOS) of axi-cel, liso-cel, tisa-cel, pola-BR, Tafa-L, and ritux-

imab-gemcitabine-oxaliplatin (R-GemOx) in 3+L DLBCL. First-year

treatment costs were calculated. Treatment costs and mOS values were

plotted in one EF graph. Sensitivity analyses using Monte Carlo sim-

ulations were performed to verify point estimates of clinical benefit

values.

Result: e EF is built by R-GemOx (€29,080, mOS 12 months), Tafa-L

(€104,541, 15.5 months), and axi-cel (€308,516, 18.69 months). High

uncertainty was found for mOS of axi-cel and liso-cel. e highest

increase in value per euro is gained for Tafa-L.

Discussion: In the current treatment of transplant-ineligible r/r DLBCL,

R-GemOx, Tafa-L, and axi-cel form the cost-eectiveness threshold uti-

lized for pricing decisions of newly approved drugs, which must meet

this threshold to be rated as cost-eective. is could come into eect for

pricing decisions of loncastuximab tesirine or glotamab.

Conclusion: e EF is one element in a holistic cost-benet evaluation

and is to be understood as a dynamic tool, which may change if innova-

tion shis are obtained.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

482

Preconditions for a frictionless CAR-T therapy

process - AGroup Concept Mapping analysis

Ann-Cathrine Siefen1; Melina Sophie Kurte1,2; Florian Kron1,3,4,5

1VITIS Healthcare Group, Cologne, Deutschland

2Faculty of Medicine, University of Duisburg-Essen, Essen, Deutschland

3Department I of Internal Medicine, Faculty of Medicine and University Hospital

Cologne, University of Cologne, Cologne, Deutschland

4Center for Integrated Oncology (CIO ABCD), Faculty of Medicine and University

Hospital of Cologne, University of Cologne, Cologne, Deutschland

5FOM University of Applied Sciences, Essen, Deutschland

Background: Chimeric antigen receptor T-cell (CAR-T) therapy is an

innovative cancer therapy starting in Europe with its rst approvals in

2018. However, CAR-T therapy poses major logistical and organizational

challenges for involved stakeholders. Additionally, there are nancial

constraints due to the reimbursement of a one-time therapy and high

qualitative requirements for the CAR-T centers. us, the aim was to sys-

tematically assess the procedural challenges in CAR-T therapy and iden-

tify preconditions for a frictionless process.

Methods: A Group Concept Mapping (GCM) analysis, a mixed methods

participatory research method, was conducted in two phases. In phase 1,

participants collected statements completing the following focus prompt:

“To ensure that the CAR-T cell therapy process - from initial indication to

follow-up - runs as frictionless as possible, it takes ...?”. In Phase 2, partic-

ipants were asked to a) group statements based on similarity and b) rate

their importance and feasibility. Multivariate analyses were depicted in

a cluster (or concept) map reecting the main topics. Results were com-

bined with calculated average ratings.

Result: Participants consisted of CAR-T experts from dierent profes-

sions. 11 + x (Adboard + remote contributions) participants completed

phase 1 collecting 214 and x statements, respectively (x nal statements

aer data cleansing). In phase 2, x participants rated and sorted the state-

ments generating a concept map consisting of the x following clusters

(from highest to lowest average importance rating): x, x, x, and x.

Discussion: is is the rst German mixed-methods study capturing pre-

conditions for reducing hurdles in the CAR-T therapy process. It reects

various perspectives and allows prioritizing the collected preconditions

based on their perceived importance and feasibility.

Conclusion: Future eorts should focus on providing the identied

preconditions for a frictionless process, starting with high-priority

aspects. Structured cost analyses could quantify the eort required for its

implementation.

Disclosure Statement: e authors declare the following: A-C Siefen, MS Kurte,

and F Kron are employees of the VITIS Healthcare Group, which was sponsored

by GILEAD Sciences GmbH in connection with the development of the study. e

funder of the study had no role in study design, data analysis, or data interpreta-

tion and writing of the abstract.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts146

583

Pseudoprogression in multiple myeloma patients treated with

Anti-BCMA CAR-T cells

Max Topp; Sven Schimanski; Hannah Hornburger; Sophie Kadel;

Hermann Einsele; Leo Rasche; Johannes Düll

Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Würzburg,

Deutschland

Background: Immunotherapy of relapsed/refractory multiple myeloma

(RRMM) patients with anti-BCMA CAR-T cells results in an objective

response rate of up to 95%. Incidence, presentation, management and out-

come of pseudoprogression aer CAR-T infusion has not been reported

in RRMM patients.

Methods: RRMM patients treated with either Ide-Cel or Citla-Cel aer

CAR-T infusion were followed for pseudoprogression aer CAR-T

infusion.

Result: 44 RRMM patients were infused with either commercially available

CAR-T cells; Ide-Cel (n=36) or Citla-Cel (n=8); between November 2021

and August 2023. 3 out of 46 patients (6.5%) developed clinical and imag-

ing signs of pseudoprogression (bone pain and FDG PET/MRI positivity)

on day 1,3 and 5 respectively. In two patients, biopsies showed a massive

inux of activated CAR-T cells with no myeloma cells present at the site.

Interestingly, the peak of pain coincides with the peak of CAR-T expansion

in peripheral blood. e pain was treated with morphine for 5,2 and 3 days

and dexamethasone once in one patient to control symptomatic and to stop

local cytokine production. Pain resolved and medication was completely

tapered in one patient, two continued low dose Hydromorphon for about 2-4

weeks. All 3 subjects achieved a MRD negative CR at month 3 and remain

in remission.

Discussion: is is the rst report on the incidence and management of

pseudoprogression in RRMM patients treated with anti-BCMA CAR-T

whereby pseudoprogression appears to have a similar incidence in RRMM

as in NHL patients1 treated with CAR-T.

Conclusion: Pseudoprogression is not uncommon in RRMM treated with

anti-BCMA CAR T cells and can be successfully managed with painkillers

and steroids without aecting the response.

Reference:

1. Immune imitation of tumor progression aer anti-CD19 chimeric antigen

receptor T cells treatment in aggressive B-cell lymphoma. Ivetta Danylesko

et al. Bone Marrow transplantation 56:1134–1143, 2021.

Disclosure Statement: e authors declare no conict of interest.

595

Eectiveness of dierent oncolytic vaccinia virus strains for

the in vitro and in vivo treatment of peritoneal mesothelioma

Can Yurttas1,2; Julia Beil2,3,4; Berchtold Susanne2,3; Irina Smirnow2,3;

Linus D. Kloker2,3; Bence Sipos3,4,5; Alfred Königsrainer1,4; Andre Mihaljevic1;

Ulrich Lauer2,3,4; Karolin Thiel1

1Department of General, Visceral and Transplant Surgery, University Hospital of

Tübingen, Tübingen, Deutschland

2Virotherapy Center Tübingen (VCT), Department of Medical Oncology and

Pneumology, University Hospital of Tübingen, Tübingen, Deutschland

3Department of Internal Medicine VIII, Medical Oncology and Pneumology,

University Hospital of Tübingen, Tübingen, Deutschland

4German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ),

Partner Site Tübingen, Tübingen, Deutschland

5BAG für Pathologie und Molekularpathologie Stuttgart, Stuttgart, Deutschland

Background: Eective treatment for peritoneal surface malignancies

(PSM) is scarce. Oncolytic virotherapy with recombinant vaccinia viruses

might constitute a novel treatment option for PSM. We aimed to identify

the most eective oncolytic vaccinia virus strain in two murine mesotheli-

oma cell lines and the oncolytic potential in a murine model of peritoneal

mesothelioma.

Methods: Cell lines AB12 and AC29 were infected in vitro with vaccinia

virus strains Lister (GLV-1h254), Western Reserve (GLV-0b347) and

Copenhagen (GLV-4h463), kindly provided by Genelux, Westlake Village,

California, USA. Feasibility, safety and eectiveness of intraperitoneal

virotherapy were assessed by determination of the peritoneal cancer index

(PCI), virus detection in tumor tissues and ascites, virus growth curves

and comparison of overall survival in mesothelioma-bearing mice.

Result: Oncolytic vaccinia virus strain GLV-0b347 was found to be most

eective in terms of oncolysis and viral replication in both murine cell

lines AB12 and AC29. Aer i.p. injection of GLV-0b347, virus was detect-

able in tumors and ascites aer 24 and 48 h post infection, overall sur-

vival was signicantly prolonged, and development of ascites and PCI was

decreased (in comparison to mock-treated mice) whereas no viral spread

to the blood or brain was detected. e observations made were found to

depend on the amount of tumor cells and the time from tumor implanta-

tion to virus application.

Discussion: Vaccinia virus strain GLV-0b347 was identied to be most

eective in vitro. In vivo, this Western Reserve virus strain was frequently

detectable in tumors and ascites of virus-treated mice enabling signi-

cantly prolonged animal survival. Next, treatment modications and

combinational therapy approaches will be investigated to further enhance

eectiveness.

Conclusion: Intraperitoneal virotherapy using vaccinia virus construct

GLV-0b347 was shown to be feasible, safe and eective when treating

peritoneal mesothelioma in a murine model.

Disclosure Statement: e authors declare no conict of interest.

625

Stearoyl-CoA desaturase in CD4+ T cells suppresses tumor

growth through activation of CXCR3/CXCL11-axis in CD8+

Tcells

yongbaek kim

College of Veterinary Medicine, Seoul National University, Seoul, Republik Korea

Within tumor microenvironment, altered lipid metabolism promotes can-

cer cell malignancy via activation of oncogenic cascades, but its impact

on the tumor-inltrating lymphocytes (TILs) remains poorly understood.

Here, we demonstrated that treatment with CAF-supernatant enhanced

the expression of stearoyl-CoA desaturase (SCD) and increased the pro-

duction of oleic acid (OA) in CD4+ T cells under glucose-decient con-

dition. Enhanced SCD promoted the dierentiation of Jurkat cells toward

1 cells with increased expression of T-bet, IL-2, and IFN-γ. In contrast,

inhibition of SCD upregulated the expression of regulatory T (Treg) cell

markers, Foxp3 and TGF-β. Comparative fatty acid analysis of genetically

engineered Jurkat cells revealed that OA was signicantly higher in SCD-

overexpressed cells. Meanwhile, saturated fatty acid like palmitic acid (PA)

was more prevalent in SCD-KO cells with upregulated mitochondrial

superoxide. Indeed, the expression of markers for 1 and Treg cells were

regulated by treatment with OA or PA, respectively. Furthermore, SCD

conferred a secretion of C-X-C motif chemokine ligand 11 (CXCL11)

from CD4+ T cells. Binding of CXCL11 with C-X-C chemokine receptor 3

(CXCR3) on CD8+ T cells augmented their cytotoxic activity and CXCR3

expression. In mouse tumor model, suppressive eect of CD8+ T cells on

tumor growth was dependent on CXCR3 expression. ese ndings illus-

trated that the SCD not only orchestrated dierentiation of T helper cells

but also promoted the antitumor activity of CD8+ T cells, suggesting its

function in adverse tumor microenvironment.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 147

676

Successful treatment with chimeric antigen receptor (CAR)

T-lymphocytes of an adult patient with relapsed and

refractory (r/r) Philadelphia Chromosome (Ph) positive acute

lymphoblastic leukemia (ALL) after allogeneic hematopoietic

stem-cell transplantation (allo-HSCT) - a case report

Sebastian Wegener1; Olaf Hopfer2; Georg-Nikolaus Franke1;

Madlen Jentzsch1; Michael Kiehl2; Uwe Platzbecker1; Vladan Vucinic1

1University Leipzig Medical Center, Department for Hematology, Cell therapy,

Hemostaseology and Infectious Diseases, Leipzig, Deutschland

2Department of Internal Medicine I, Frankfurt (Oder) General Hospital,

Frankfurt/Oder, Deutschland

Background: e prognosis of patients (pts) with r/r Ph+ ALL is unfa-

vorable, especially when relapsing aer allo-HSCT with limited thera-

peutic options. CAR-T cell treatment is a promising option, but the data

regarding CAR-T in post allo-HSCT pts is limited.

Methods: Hematologic response was assessed according to current guide-

lines. Here we present a case of a 44-year-old Caucasian male pt with Ph+

ALL successfully treated with CAR-T cells aer prior allo-HSCT.

Result: e pt presented in September 2022 with Ph+ common B-ALL.

He was diagnosed 2017 and treated according to the German ALL proto-

col with imatinib, two inductions and one consolidation chemotherapy,

followed by an allo-HSCT from matched unrelated donor. e treatment

led to complete remission (CR) without measurable residual disease

(MRD). In 2019, BCR::ABL1 was again detected and due to a resistance

mutation, the pt was treated with dasatinib and donor lymphocyte infu-

sions (DLI) were applied, without eect on the BCR::ABL1 burden. In

September 2022, he relapsed with 26% blasts in peripheral blood. Aer

three courses of inotuzumab-ozogamicin the pt was in MRD-positive CR

and underwent treatment with brexucabtagene-autoleucel (brexu-cel).

He developed cytokine release syndrome grade 2 and immune eector

cell associated neurotoxicity syndrome grade 3 shortly aer reinfusion

and both complications resolved completely. 15 days aer reinfusion,

bone marrow smear showed CR with a relevant decrease of MRD, and

three months aer, MRD-negative CR and a 100% donor chimerism. Six

months aer brexu-cel the pt underwent a 2nd allo-HSCT and is cur-

rently, three months aerwards, in ongoing MRD-negative CR without

signs of gra-vs- host disease.

Discussion: Brexu-cel is an eective and promising new therapeutic

option in the treatment of r/r ALL also in pts aer previous allo-HSCT.

Conclusion: Our heavily pretreated r/r pt achieved an MRD-negative

CR 3 months aer reinfusion. Further trials are necessary to dene the

denitive curative potential of CAR T treatment in r/r ALL pts, esp. aer

previous allo-HSCT.

Disclosure Statement: e authors declare the following: UP and VV: Honoraria

from BMS-Celgene, Novartis, Gilead/Kite, Janssen; Travel Grants from: Janssen,

BMS-Celgene, Gilead/Kite. MJ: Honoraria Novartis, BMS/Celgene. GNF: Hono-

raria Novartis, Gilead/Kite. MK, OH and SW have nothing to disclose.

688

Treatment of patients with ALL or NHL with third-generation

CD19-directed chimeric antigen receptor (CAR) T cells –

updated results of the Heidelberg trial 1 (HD-CAR-1 trial)

Maria-Luisa Schubert1; Anita Schmitt1; Simon Haas2; Patrick Derigs1;

Schayan Yousean2; Felix Korell1; Tim Sauer1; Anthony D. Ho1;

Carsten Müller-Tidow1; Peter Dreger1; Michael Schmitt1

1Department of Internal Medicine V, University Hospital Heidelberg, Heidelberg,

Deutschland

2BIH - Charité, Berlin, Deutschland

Background: ird-generation chimeric antigen receptor (CAR)-

engineered T-cells (CARTs) might improve clinical outcome of patients

with B-cell malignancies. Here we report a phase-1/2 investigator-initiated

trial (HD-CAR-1) on a third-generation CART dose-escalating, treating

adult patients with acute lymphoblastic leukemia (ALL) or non-Hodgkin’s

lymphoma (NHL).

Methods: HD-CAR-1 is designed to evaluate escalating doses of

third-generation (CD28 and 4-1BB (CD137) costimulatory domains)

CD19-directed CARTs (1×106 to 2×108 CARTs/m2) aer lymphodepletion

with udarabine and cyclophosphamide. Leukapheresis, manufacturing

and administration of CARTs, patient monitoring and follow-up are per-

formed in-house at the GMP Core Facility of the Heidelberg University

Hospital. In addition to r/r NHL patients, adult patients with r/r ALL are

eligible.

Results:40 patients with r/r ALL or r/r NHL were enrolled. Patients had

received a median of 4 (range 2 to 9) prior treatment lines, including allo-

geneic stem cell transplantation (alloSCT). For all patients, CART manu-

facturing was feasible. Patients were treated with 1 to 200 million CART

cells/sqm. None of the treated patients developed any grade of immune

eector cell-associated neurotoxic syndrome (ICANS) or a higher-grade

(≥ grade III) cytokine release syndrome (CRS).

Response and outcome were associated with the administered CART dose.

At 3-year-follow-up, overall survival (OS)/progression free survival (PFS)

was 70%/50 % and 50%/25% for NHL and ALL patients, respectively.

Lack of CD39-expression on memory-like T cells was more frequent

in CART products of responders when compared to CART products of

non-responders. Aer CART administration, higher CD8 + and γδ-T cell

frequencies, a physiological pattern of immune cells and lower monocyte

counts in the PB were associated with response.

Conclusions: In conclusion, third-generation CARTs were associated

with promising clinical ecacy and remarkably. Responders displayed

higher frequencies of a specic memory-like T cell subset within the

CART-product.

Disclosure Statement: e authors declare the following: Unrestricted grants from

Kite/Gilead, Novartis, BMS and Janssen.

697

Ciltacabtagene autoleucel compared to standard of care in

triple-class exposed multiple myeloma: combined analyses

of adjusted comparison of CARTITUDE-1 and prospective

real-world cohort LocoMMotion with data from the

randomized controlled trial CARTITUDE-4

Christina Schulat1; Janine Jakobs1; Ronja Kerßenboom2; Joris Diels3;

Francesca Ghilotti3; Pushpike Thilakatathne3; Jedelyn Cabrieto3;

Nolen Joy Perualila3; Sandra van Hoorenbeeck3; Lewin Eisele2;

Andreas Blees2; Jörn Sindern2; Christof Scheid4

1Janssen-Cilag GmbH, Neuss, Deutschland

2Janssen-Cilag GmbH, Neuss, Deutschland

3Janssen Pharmaceutica, Beerse, Belgien

4Uniklinik Köln, Köln, Deutschland

Background: Ciltacabtagene autoleucel (ciltacel) is currently indicated

for patients with multiple myeloma (MM) who received at least three

prior lines of therapy, are triple-class exposed and refractory to last line

of therapy (in-label population). is analysis aims to assess the overall

survival (OS) of the in-label population treated with ciltacel compared to

standard of care (SoC) and was conducted to address the requirements of

the German health technology assessment (HTA).

Methods: e Phase 1b/2 single-arm trial CARTITUDE-1 enrolled 124

in-label patients. CARTITUDE-4 is a Phase 3 randomized controlled trial

(RCT) comparing ciltacel to two regimens of physician’s choice (PC) in

patients with MM, who received one to three prior lines of therapy and

are refractory to lenalidomide. It includes a subgroup of 20 (ciltacel) vs. 29

(PC) in-label patients. LocoMMotion is a prospective real-world evidence

cohort designed as an external control arm for a target trial emulation

(TTE) with CARTITUDE-1. It enrolled 110 in-label patients, who fullled

all CARTITUDE-1 inclusion criteria and received SoC regimens consid-

ered appropriate comparator treatment (ACT) by the German HTA body.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts148

e adjusted comparison of CARTITUDE-1 and LocoMMotion was

complemented with patients from the ciltacel and the PC arms from

CARTITUDE-4, respectively. Potential confounding factors were identi-

ed systematically and adjusted for using Inverse Probability Weighting

(IPW) methods and Propensity Score Matching (PSM).

Result: Naïve comparison yielded an OS hazard ratio (HR) of 0.38 (95%

CI: 0.26, 0.56) in the in-label population. Results from IPW and PSM

approaches are highly consistent with HR ranging from 0.31 to 0.43.

Discussion: By combining the TTE with RCT data, comparability of

patient characteristics between treatment groups was increased with con-

sistent OS results. Potential confounding was addressed by IPW-methods.

PSM conrmed the positivity of the study populations.

Conclusion: e analyses provide valid results showing that ciltacel sub-

stantially prolongs OS compared to SoC.

Disclosure Statement: e authors declare the following: wirtschaliche oder

persönliche Verbindungen zu Unternehmen der Gesundheitswirtscha.

702

Tumor Treating Fields (TTFields) may be utilized to increase

temozolomide and lomustine ecacy in glioblastoma

celllines

Hila Fishman1; Roni Monin1; Eyal Dor-On1; Adi Haber1; Bastian Gastl2;

Moshe Giladi1; Uri Weinberg1; Yoram Palti1

1Novocure Ltd, Haifa, Israel

2Novocure GmbH, Munich, Deutschland

Background: Glioblastoma (GBM) is the most frequent type of primary

malignant brain tumor in adults. Temozolomide (TMZ) is standard of

care for newly diagnosed GBM (ndGBM). e lack of response to TMZ in

some patients may be attributed to the expression of MGMT, an enzyme

implicated in repairing DNA damage triggered by TMZ. Tumor Treating

Fields (TTFields) are electric elds that disrupt critical cellular process

involved in cancer cell survival and tumor progression. TTFields therapy

applied concomitantly with TMZ is an approved treatment for ndGBM.

A recent study demonstrated clinical benets of TMZ and lomustine

(CCNU) co-treatment. is study aimed to examine the eect of TTFields

concurrent with TMZ and CCNU in GBM cells.

Methods: Human GBM cells (U-87 MG, LN229, U118, LN18) with vary-

ing MGMT expression levels were subjected to TTFields (0.83 V/cm RMS,

200 kHz) together with TMZ and/or CCNU and assessed for eective-

ness using cell counts and colony formation. Additionally, the impact of

TTFields on expression of proteins from the Fanconi anemia (FA)-BRCA

DNA repair pathway was analyzed using western blot.

Result: TTFields and TMZ concomitant application demonstrated an

additive eect, independent of MGMT expression levels. e eect of

TTFields concomitant with CCNU was additive in MGMT-expressing

cell lines and showed potential of synergism in cell lines lacking MGMT

expression. Treatment eectiveness was further enhanced when TTFields

was applied concurrently with both TMZ and CCNU. TTFields were

shown to decrease the expression of proteins in the FA-BRCA pathway,

which is involved in the repair of CCNU (but not TMZ) induced DNA

damage in the absence of MGMT.

Discussion: Regardless of cellular MGMT expression levels, TTFields

therapy concomitant with TMZ and/or CCNU increased treatment e-

cacy. e BRCAness state induced by TTFields justies the synergy seen

for TTFields with CCNU, especially in cells lacking MGMT.

Conclusion: ese ndings suggest that TTFields therapy administered

concomitantly with TMZ/CCNU may have potential treatment benet for

GBM.

Disclosure Statement: e authors declare the following: All authors are employ-

ees and hold stock in Novocure.

722

Eectiveness and safety outcomes in patients with EBV+PTLD

treated with allogeneic EBV-specic T-cell immunotherapy

(tabelecleucel) under an expanded access program (EAP)

in Europe

Ralf Ulrich Trappe1; Sylvain Choquet2; Andrew Clark.43; Cécile Renard4;

Sridhar Chaganti5; Patrizia Comoli6; Xinyuan Duan7; Baodong Xing7;

Charley Wu7; Laurence Gamelin7; Jan-Henrik Terwey8; Anke Friedetzky8;

Daan Dierickx9

1DIAKO Ev. Diakoniekrankenhaus, Bremen, Deutschland

2Pitié-Salpêtrière Hospital, Paris, Frankreich

3NHS Greater Glasgow and Clyde, Glasgow, United Kingdom

4Hospices Civils de Lyon, Lyon, Frankreich

5University Hospitals Birmingham NHS Trust, Birmingham, United Kingdom

6Fondazione IRCCS Policlinico San Matteo, Pavia, Italien

7Atara Biotherapeutics, Thousand Oaks, USA

8Atara Biotherapeutics Switzerland GmbH, Zug, Schweiz

9University Hospitals Leuven, Leuven, Belgien

Background: Pts with relapsed or refractory (r/r) EBV+ PTLD in Europe

have had historically poor ORR and median OS with no approved treat-

ment options. Tabelecleucel (Tab-cel), an o-the-shelf, allogeneic EBV-

specic T-cell immunotherapy has shown clinical benet and favorable

safety prole in the ttt of EBV+ PTLD failing rituximab ± chemotherapy.

Its recent European marketing authorization represents the 1st approval

of an allogenic T-cell immunotherapy.

Methods: Atara Bio supported expanded access requests for Tab-cel

in Europe. Here we report updated eectiveness and safety data for r/r

EBV+ PTLD pts who provided consent for research between Sep 2020

and Dec 2022.

Result: 74 EAP requests were received from 10 countries for pts with

r/r EBV+ diseases. 27 EBV+ PTLD pts consented to secondary use of

data and 24 pts had received ≥1 dose of Tab-cel, including 4 pts with

primary central nervous system (PCNS) PTLD. 16 of 24 (66.7%) PTLD

pts achieved a partial (PR) (33.3%) or complete response (CR) (33.3%),

with median time to response (TTR) of 1.0 mo (0.8–2.2). Response

rate for PCNS PTLD pts was 75% (1 CR, 2 PR). 1-yr OS Kaplan–Meier

(KM) estimate rates were 73.7% (95% CI: 47.3, 88.3) overall, 87.5%

in allogeneic HCT and 66.5% in solid organ transplant (SOT), with a

median follow-up time of 9.9 (2.4–13.9) and 6.0 (0.7–18.0) mo, respec-

tively. Serious ttt-emergent adverse events (TESAEs) were reported in 7

(29.2%) pts, including 1 fatal event of disease progression. Predened

risks for Tab-cel were reported in 3 pts; 1 (4.2%) SOT pt had a TESAE of

liver transplant rejection (grade 2) and 2 (8.3%) HCT pts had non-seri-

ous TEAEs of chronic gra-versus-host disease (grade 1 and 2). No cases

of cytokine release syndrome or tumor are reaction were reported. No

AEs were reported as related to Tab-cel by the treating physician.

Conclusion: ese updated real-world results for pts with r/r EBV+

PTLD post-HCT or post-SOT treated in the European EAP continue to

reinforce the favorable risk:benet prole of Tab-cel and are in line with

clinical study data supporting its recent EMA approval.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 149

864

Targeting lysosomal Acid Lipase activity as a novel

therapeutic approach for Pancreatic ductal adenocarcinoma

(PDAC)

Elisa Katharina Schürmann1,2; Dieter Niederacher1,2; Hans Neubauer1,2;

Nikolas H. Stoecklein2,3; Tanja Fehm1,2; Knud Esser1,2

1Klinik für Frauenheilkunde und Geburtshilfe, Düsseldorf, Deutschland

2Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland

3Klinik für Allgemein-, Viszeral- und Kinderchirurgie, Düsseldorf, Deutschland

Background: Lipid metabolic reprogramming contributes to the main-

tenance of cancer high stemness and is supposed to represent one major

characteristic of PDAC causing its extraordinary high malignancy.

erefore, targeting Lysosomal Acid Lipase (LIPA), signicantly overex-

pressed in PDAC, with Lalistat, a specic LIPA inhibitor, is analysed in

these studies to increase chemosensitivity to Paclitaxel and Folrinox and

to reduce metastasis in PDAC.

Methods: PANC-1 and MIA PaCa-2 cell lines were used as in vitro mod-

els. e cells were pre-incubated with Lalistat and DMSO (as a control)

at dierent concentrations for three days. Chemotherapeutics were then

added to the given Lalistat and DMSO concentrations for further three

days. Cell viability was analysed using the CellTiter Glo® assay.

Result: PANC-1 and MIA PaCa-2 cells exhibited a signicantly higher

chemosensitivity to Paclitaxel and Folrinox when incubated with Lalistat

compared to the cells incubated with DMSO.

Discussion: We have successfully demonstrated the impact of phar-

macological LIPA inhibition in generating a higher chemosensitivity to

Paclitaxel and Folrinox in cell culture models of PDAC. Further stud-

ies with Lalistat and Folrinox will be performed in the chorio-allantoic

membrane (CAM) model to investigate the in vivo eects with regard to

tumor proliferation and metastasis.

Conclusion: Our studies suggest that pharmacological inhibition of LIPA

has a high potential to improve current PDAC therapy and to oer new

targeted therapeutic options in the future.

Disclosure Statement: e authors declare no conict of interest.

871

In vitro live cell imaging for testing new anticancer therapies

to predict in vivo treatment ecacy

Dennis Kobelt; Maria Stecklum; Simone Rhein; Walther Wolfgang;

Jens Homann

EPO Berlin-Buch GmbH, Berlin, Deutschland

Background: e preclinical evaluation of novel cancer treatments like

immune cell based therapies and small molecule inhibitors demands com-

prehensive model systems in vitro that provide meaningful data before

entering in vivo studies. Here we evaluate the capabilities of live cell imag-

ing systems to evaluate novel immune cell therapies. Using immune cell

and small molecule based combinatorial approaches in vitro we demon-

strate, that these model systems can generate reliable data of pharmacody-

namic activity for further preclinical in vivo characterization.

Methods: Target cell killing was assessed in vitro with activated immune

cells. For combinatorial small molecule testing, conuent monolayers

were scratched. Cells were monitored every 2nd hour using the IncuCyte.

Dose-response-curves of single treatments and all combinations were

generated in parallel. For the in vivo validation, humanized mice were

generated by injection of CD34+ HSC or human immune cell subsets.

Immune cell engrament was monitored by FACS. To analyze the eect

of small molecule treatment, tumor cells were transplanted into spleens of

mice. Tumor development was monitored by BLI.

Result: Target cell killing by immune cells and monolayer wound healing

in 96 well format were successfully monitored in the IncuCyte. Here, data

can be generated over time without the need of new samples at every time

point compared with conventional end point measurements. ese data

predicted in vivo treatment outcome. Aer successful humanization of

mice, immune cells can be directed to kill tumor cells. Small molecule

combinations showing ecacy in vitro were most successful in vivo.

Discussion/Conclusion: e IncuCyte System provides in vitro data

that can directly translate into in vivo studies. We have shown activated

immune cells can kill target tumor cells in vitro. ese data have been

validated in in vivo experiments using immune cell humanized mice.

Further, small molecule based treatments can be tested either alone or in

combination allowing the preselection of active combinations for further

development.

Disclosure Statement: e authors declare the following: All authors are employ-

ees of EPO Berlin-Buch GmbH. JH is CEO of EPO Berlin-Buch GmbH.

884

Patients with colorectal and pancreatic cancer in the

Molecular Tumor Board of a Center for Personalized Medicine

Julia Didion1; Rika Jurkschat2; Lukas Perkhofer1; Stephan Stilgenbauer3;

Verena Ingeborg Gaidzik2,4; Thomas J. Ettrich1; Angelika Kestler1;

Thomas Seuerlein1,2

1Universitätsklinikum Ulm, Klinik für Innere Medizin I, Ulm, Deutschland

2Zentren für Personalisierte Medizin, Ulm, Deutschland

3Comprehensive Cancer Center Ulm (CCCU) am Universitätsklinikum Ulm, Ulm,

Deutschland

4Universitätsklinikum Ulm Klinik für Innere Medizin III - Hämatologie, Onkologie,

Rheumatologie, Infektionskrank., Ulm, Deutschland

Background: Personalized treatment strategies based on NGS sequencing

gain increasing importance in the treatment of patients with advanced

solid tumors. Results of tumor sequencing by large NGS panels or RNA

sequencing of patients with advanced tumors and no further established

treatment options are discussed in the molecular tumor board (MTB). In

case a druggable target that is likely to constitute a tumor driver is found,

o label used of targeted agents is supported by public health insurance.

Here we report the journey of patients with advanced pancreatic (PDAC)

and colorectal cancer (CRC) in the MTB at Ulm University hospital.

Methods: All patients with advanced PDAC and CRC discussed in the

MTB of the ZPM Ulm from 1/2020 until 6/2023 and who gave consent

were evaluated.

Result: 72 patients with advanced CRC (n=40) or PDAC (n=32) were

discussed in the MTP Ulm. In 47 patients no treatment could be recom-

mended. 25 patients received a treatment recommendation. 11 patients

died before initiation of therapy. 5 patients were lost to follow up. 1 patient

received another treatment. In 2 cases the application to the health insur-

ance company is still pending. 6 patients received the recommended

treatment (CRC: Trametinib, olaparib, trastuzumab-deruxtecan PDAC:

Palbociblib, pemigatinib, selumetinib). ere was one partial remission,

2 patients with stable disease and 3 patients with progressive disease as

best response.

Discussion: In this case series 8% of patients did receive a targeted treat-

ment aer recommendation by the MTB of which 50% benetted from

the treatment. is gure is below that reported from other MTB case

series. However, it has to be considered that only 2 rather dicult to treat

entities, advanced CRC and PDAC were included in the analysis.

Conclusion: NGS-based tumor analysis can achieve a benet for patients

with advanced, dicult-to-treat cancers. In future other means of analysis

but only gene sequencing shall be implemented to further improve target

identication in these tumors.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts150

911

Persistent Genetic Modication of Human Hematopoietic

Stem and Progenitor Cells Using S/MAR DNA Nanovectors

Patrick Derigs1,2; Alicia Roig-Merino3; Julia Peterson2; Luisa Burger2;

Sandra Sauer1; Tim Sauer1; Carsten Müller-Tidow1; Michael Schmitt1;

Richard Harbottle2

1Department of Internal Medicine V (Hematology, Oncology and

Rheumatology), University Hospital Heidelberg, Heidelberg, Deutschland

2DNA Vector Lab, German Cancer Research Center, Heidelberg, Deutschland

3MaxCyte, Inc., Gaithersburg, USA

Background: Transplantation of hematopoietic stem and progenitor

cells (HSPCs) electroporated with drug resistance inducing genes would

ensure eective tumor suppression by applying respective anticancer

therapy while maintaining sucient hematopoiesis in cancer patients.

Eective strategies for the persistent genetic modication of HSPCs are

needed for this treatment approach. Recombinant integrating viruses are

a potent and widely used tool. However, their random integration into the

genome introduces a risk of insertional mutagenesis. eir innate immu-

nogenicity presents another impediment to clinical application.

Methods: To achieve the goal of an ecient and safe generation of stably

transfected cells of a variety of cell types, we have developed a non-vi-

ral DNA vector platform based on Scaold/Matrix-Associated Regions

(S/MAR). e episomal maintenance of S/MAR DNA nanovectors (nS/

MAR) eradicates the risk of insertional mutagenesis, providing a major

advantage compared to already clinically applied approaches using

CRISPR/Cas9 systems or viral vectors. Additionally, with its unlimited

capacity, even large therapeutic transgenes or other sophisticated genetic

elements can be delivered with nS/MAR. In this study, we have evalu-

ated the eciency and persistence of reporter transgene expression in

the hematopoietic cell line K562 and primary human HSPCs using nS/

MAR. For electroporation the MaxCyte ExPERT® platform was used.

Transfection eciency and cell viability were analyzed by ow cytometry.

Results: Our study demonstrates the feasibility of using nS/MAR for

persistent genetic modication of K562 and HSPCs. Initial transfection

eciencies of primary human HSPCs of three dierent donors were high

with up to 82% positive cells. Transfected HSPCs retained reporter trans-

gene expression for 21 days in culture.

Conclusion: ese ndings provide a promising rst step towards the

persistent genetic modication of HSPCs with nS/MAR and their usage

in hematopoietic cell transplantation for the treatment of cancer patients.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

Oncological Pharmacy

427

Interferon-lambda (IFNL) germline variants and

responsiveness to chemo- and radiotherapy in cancer patients

Mia Mala Hafemann; Sabine Mihm

Universitätsmedizin Göttingen, Klinik für Gastroenterologie, gastrointestinale

Onkologie & Endokrinologie, Göttingen, Deutschland

Background: Chemo- and radiotherapy are known to trigger immune

activation via type I interferon (IFN) induction1. Time-event analyses of

ductal pancreatic adenocarcinoma (PAAD) and hepatocellular carcinoma

(HCC) patients revealed an association between IFNL gene variants and

PAAD disease progression, while this did not apply to HCC2. As PAAD

patients undergo chemotherapy at higher rates than HCC patients do, we

hypothesized that IFNL polymorphisms predispose for PAAD disease

progression via modulating therapy responsiveness.

Methods: IFNL genotypes (IFNL4 rs368234815 (TT/G) and surro-

gates) were read out from TCGA (e Cancer Genome Atlas) projects

with sucient chemo- or radiotherapy response data (i.e., BLCA, BRCA,

LUAD, PAAD, SARC, SKCM). Genotypes were analyzed for associations

with relevant clinical data.

Result: Genotype distributions in the respective cancer patient samples

reected those provided by the 1000 Genomes Project, except for mel-

anoma. Clinical data revealed virtually no association with IFNL geno-

types. A more in-depth analysis considering the P70S variant aecting

IFN-λ4 function and a stratication with regard to anthracyclines also

revealed no relation to therapy outcome.

Discussion: e deviation in allele distribution from the 1000 Genomes

Project reference sample in melanoma might point towards an allele-

driven tumor risk modulation. As analyses argue against the assumption

that the association between IFNL genotypes and PAAD disease pro-

gression is attributable to therapy response, further options are going

to be tested.

Conclusion: e association between IFNL variants and PAAD disease

progression appears not to be due to therapy responsiveness.

Indication of source:

1. Sistigu A, et al. (2014): Cancer cell-autonomous contribution of type I

interferon signaling to the ecacy of chemotherapy. Nat Med 20, 1301.

2. Huschka H, Mihm S (2020): IFNL germline variations and their signicance for

HCC and PDAC progression: an analysis of TCGA data. BMC Cancer 20, 1131.

Disclosure Statement: e authors declare no conict of interest.

435

Standardized patient information leaets for oral

anticancerdrugs

Jelena Rosentreter1; Clément Carbasse2; Klaus Meier1

1ESOP Global (European Society of Oncology Pharmacy), Hamburg,

Deutschland

2Service UPO – CHU de Nîmes, Nîmes, Frankreich

Background: e European Society of Oncology Pharmacy (ESOP

Global) has multiple “special interest groups” (SIG). e SIG “oral anti-

cancer drugs” (OAD) has, among others, the objective to improve health

literacy in oncology patients. Written patient information leaets (PIL)

about OAD are important for patient education. Until now, there are no

multi-national standards for PIL about OAD.

Methods: Aer six online meetings over the course of one year, the SIG

organized a live workshop in July 2023. e goal was to agree on a stan-

dardized template (ST) for PIL about OAD. e available national PIL

were used as sources.

Result: Out of the 13 countries represented in the SIG, eleven members

from eight countries participated in the workshop. e national PIL dier

greatly from one another. For the ST, a brief format (max. two pages) and

12 categories in patient friendly language were agreed on. ese catego-

ries are: international nonproprietary name (INN) of the OAD (optional:

brand name), photo of the OAD (optional), “Why are you taking this

medication?”, “How to take your medication”, “What should you do if

you forget your medication or if you vomit?”, handling and storage, spe-

cic precautions, interactions, “e most common side eects that you

can recognize yourself”, “When should you contact a healthcare profes-

sional?”, local contact and emergency number, disclaimer.

Discussion: Creating a ST for PIL about OAD is a rst step towards

improving health literacy in oncology patients. Using the ST for selected

OAD as an example, the SIG needs to reassess suitability and comprehen-

sibility of the PIL, users’ acceptance as well as organizational matters, e.g.,

translation and distribution via ESOP Global.

Conclusion: Pooling multi-national knowledge has led to a new and

unique ST for PIL about OAD. e SIG’s joint work will need to continue

to pursue its goal of improving patient education. e aim is to make the

ST broadly available to ensure easy and global access and usage.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 151

751

Multi-professional database to improve adherence to oral

anticancer drugs

Klaus Meier1,2; Franziska Ockert-Schön2; Jelena Rosentreter2; Pauline Dürr2

1IFAHS, Hamburg, Deutschland

2DGOP, Hamburg, Deutschland

Background: Since 20 years research conrms that adherence to oral

medications is not guaranteed.(1) is can lead to signicant side eects

or loss of therapy, especially with oral cancer medicines with a narrow

therapeutic range. is calls for increased counselling(2) to improve

adherence.

Methods:. In most countries of the world, appropriate counselling in clin-

ics specialised in cancer treatment is mainly carried out by pharmacists

with positive results.(3) Since in Germany, oncology practices in private

practice prescribe these drugs and only public pharmacies are allowed

to dispense oral drugs in regular care, this increases the demands on the

individual professions and their professional skills.(4)

Result: To promote inter-professional communication and improve

adherence, the DGOP created a database 10 years ago in which both the

crucial information about the mode of action and the side eects and

interactions are available online and individualised intake sheets and doc-

umentation options can be created for the patient. Currently, 133 mon-

ographs and 25 co- medicines or medicines that are taken “as needed”

(PNR medicines) can be retrieved. 503 pharmacies use the database. 819

intake planes were prepared for advising patients in the last year alone.

Discussion: e evaluation of the intake forms will provide company-in-

dependent anonymous user data to assess the additional counselling

potential and PRO patient-related outcome.

Conclusion: Continuous counseling supported by a database provides

sustainable progress in treatment safety.

References:

(1) O’Neill VJ, Twelves CJ. British Journal of Cancer 2002; 87: 933–937.

(2) Osterberg L, Blaschke T. New Engl Journal Med 2005; 353: 487–497.

(3) Dennis M, Czarniak P. Journal of Cancer Education 2022; https://doi.org/

10.1007/s13187-022-02196-2.

(4) Meier K, Forum 2020; 35: 55–58 https://doi.org/10.1007/s12312-019-00742-6.

Disclosure Statement: e authors declare no conict of interest.

Onkologische Pege

Stellenwert eines Onkologischen Care-Teams auf

Lebensqualität, Autonomie und Therapietreue von

Krebspatienten in allen Phasen der Erkrankung

Beate Haensel1; Swen Wessendorf1; Janina Schrickel1; Thomas Okech2

1Cancer Center Esslingen, Esslingen, Deutschland

2Siloah Krankenhaus, Pforzheim, Deutschland

Background: Im Cancer Center Esslingen am Klinikum Esslingen

haben PatientInnen ab der Krebsdiagnosestellung die Möglichkeit

auf eine individuelle kontinuierliche Beratung, Begleitung und

Netzwerkarbeit. Innerklinisch, wie auch ambulant, telefonisch oder vor

Ort werden die PatientInnen in wesentlichen Fragen betreut und zum

Selbstmanagement angeleitet. Dies beinhaltet auch das Vorhandenseins

eines 24h Ruereitschasdienstes. Ziel der Studie ist es, den Eekt

der sektorenübergreifenden Begleitung und Beratung onkologischer

PatientInnen im Siloah Krankenhaus in Pforzheim zu vergleichen, denen

ein solches Versorgungsnetzwerk nicht zur Verfügung steht.

Methods: Mittels einer systematischen, prospektiven Befragung wurde

der Eekt einer sektorenübergreifenden Beratung und Begleitung

von krebserkrankten PatientInnen untersucht. Anhand eines

Fragebogens wurden über visuelle Analogskalen (VAS) entsprechende

Vergleichsparameter erhoben. Das PatientInnenkollektiv umfasste

PatientInnen mit einer Krebserkrankung (Erstdiagnose nicht länger als 6

Monate zurückliegend). Im Rahmen einer bizentrischen Fallkontrollstudie

wurden zu insgesamt drei Zeitpunkten Datensätze zu den Qualitäten

erapietreue, Lebensqualität und Patientenautonomie erhoben. Die

PatientInnen in Esslingen erhielten zusätzlich das Begleitungs- und

Betreuungsangebot durch STELLA Care.

Result: Insgesamt wurden 59 PatientInnen in die Studie aufgenommen.

Eine deskriptive Betrachtung der statischen Ergebnisse zeigte zum ema

Patientenautonomie einen quantitativen Unterschied. Keine Unterschiede

zeigten sich bei den Punkten erapietreue und Lebensqualität.

Conclusion: Die Wirksamkeit des Angebots von STELLA Care zeigte

sich vor allem in Bezug auf die PatientInnenautonomie. PatientInnen mit

zusätzlicher Beratung fühlten sich im Verlauf der Erkrankung weniger

überfordert. Das persönliche Sicherheitsgefühl insbesondere durch die

24stündige Erreichbarkeit war stärker ausgeprägt.

Disclosure Statement: e authors declare no conict of interest.

Integrative Nursing Interventions for Oncology Inpatients:

Results of the IMPLEMENT-UKU Project

Lea Raiber1,2; Johanna Thiele1; Klaus Kramer1

1Universitätsklinikum Ulm, Klinik für Allgemein- und Viszeralchirurgie,

Fachbereich Integrative Medizin, Ulm, Deutschland

2Interprofessionelles Graduiertenkolleg Integrative Medizin und

Gesundheitswissenschaften (IGIM), Witten, Deutschland

Background: Integrative nursing (IN) is an essential component of inte-

grative oncology. IN is dened by external, naturopathic nursing interven-

tions such as compresses, embrocation and foot/hand baths. In the project

“Implementation of IN at the University Hospital Ulm” (IMPLEMENT-

UKU), IN was initially carried out by an integratively trained nurse as a

consultation service on two oncology wards.

Methods: To ensure feasibility and acceptance of the project implemen-

tation, ongoing documentation of integrative nursing interventions (INI)

was established. Gender, age, and symptoms of the patients are docu-

mented, as well as the type of the INI, body region, oil used and duration.

Result: During the rst 12 months of the project, the consultation ser-

vice was requested by medical/nursing sta for 120 patients, of whom 110

accepted the oer of IN (91.7%). e mean age was 56.5 years, ranging

from 22 to 85 years. 59.1% were female. e most common symptoms

were restlessness and tension (37.3%), respiratory problems (33.7%),

and edema (34.9%). A total of 629 INI were performed. On average, the

patients received 5.7 INI (min=1, max=28) during their hospital stay. e

mean duration was 22 minutes (min=10, max=60). e most commonly

used INI were embrocation (84.7%) and compresses (10.0%). e most

treated body region was feet/legs (55.1%), followed by the back (25.8%)

and abdomen (8.6%). As a substance, lavender oil (28.5%) and solum oil

(24.8%) were the most frequently used.

Discussion: Acceptance of IN was high among all patients. It appears that

low-threshold INI such as embrocation and body regions such as the feet

were the main focus. e project and the further implementation of the

IN will be evaluated in an accompanying scientic research.

Conclusion: IN is an opportunity to support patients with non-pharma-

cological interventions during hospitalization. However, more in-depth

studies are needed in the future to evaluate the eects of INI in a focused

manner, as well as the eectiveness in a multimodal approach.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts152

Das Kompetenzteam onkologische Pege und Beratung - die

erfolgreiche Umsetzung der Zertizierungskriterien der DKG

in die Praxis

Silvia Krimm; Brigitte Kroh

Marienhaus Klinikum Mainz, Mainz, Deutschland

Background: Zur Gewährleistung einer umfassend fachpegerischen

Betreuung und Beratung aller Patient*innen mit onkologischen

Krankheitsbildern, gemäß den Anforderungskriterien zur Zertizierung

Onkologischer Organzentren der Deutschen Krebsgesellscha, wurde im

Marienhaus Klinikum Mainz im Jahr 2011 das Kompetenzteam onkolo-

gische Pege und Beratung (KOPB) gegründet.

Methods: Das KOPB ist integraler Bestandteil der pegerischen

Versorgung mit einem spezialisierten Angebot, welches sich am Leitbild

der Marienhausgruppe und den daraus abgeleiteten pegerischen

Vorgaben, sowie den Zertizierungskriterien der Organzentren der

Deutschen Krebsgesellscha orientiert.

Result: Aktuell besteht das Kompetenzteam onkologische Pege und

Beratung, kurz KOPB, aus sieben, nach DKG-Richtlinien weitergebildeten

Fachkrankenschwestern für Onkologie. Die eigenständige Organisation,

losgelöst vom regulären Stationsbetrieb der bettenführenden Abteilungen,

ermöglicht die volle Konzentration auf ihre Kernaufgaben. Die multipro-

fessionelle Zusammenarbeit, auch mit den supportiven Diensten innerh-

alb des Klinikums, ist, neben der individuellen Patientenbetreuung, ein

großer Bestandteil der täglichen Arbeit.

Discussion: In der Präsentation wird dargestellt, wie das KOPB organis-

iert ist, und welche Rahmenbedingungen für die tägliche Arbeit notwen-

dig sind. Es werden die Kernaufgaben des KOPB präsentiert, ebenso die

Vorteile die diese Organisationsstruktur für die einzelnen Zentren und

die Patientenbetreuung bietet. Zudem wird der Arbeitsalltag der onk. FPK

im KOPB am Beispiel des Viszeralonkologischen Zentrums dargestellt.

Conclusion: Diese Präsentation soll einen Einblick in die Tätigkeit

der onkologischen Fachpegekra geben und Anregung für andere

Einrichtungen sein, ähnliche Strukturen aufzubauen. Es wird gezeigt,

wie die Umsetzung der Zertizierungskriterien der Deutschen

Krebsgesellscha in der Praxis gelingen und auch gelebt werden kann.

Disclosure Statement: e authors declare no conict of interest.

256

Komplementäre Äußere Anwendungen bei onkologisch

Patienten mit sekundärem Lymphödem

Elke Kaschdailewitsch1; Birgit Kröger1; Bettina Noack1; Lioba Lohmüller1;

Andreas Schmitt1; Jan Valentini1; Stefanie Joos1; Regina Stolz1;

Cornelia Mahler2

1Institut für Allgemeinmedizin und Interprofessionelle Versorgung, Tübingen,

Deutschland

2Institut für Gesundheitswissenschaften Abteilung Pegewissenschaft,

Tübingen, Deutschland

Background: Onkologische Erkrankungen und ihre Behandlungen sind

die häugste Ursache für sekundäre Lymphödeme (sL). Die konventionel-

len therapeutischen Möglichkeiten sind begrenzt, insbesondere in pallia-

tiven Situationen oder wenn die Kompressionstherapie die Lebensqualität

einschränkt.

Die CCC-Integrativ Studie hat das Ziel, onkologisch Erkrankte interpro-

fessionell und evidenzbasiert zu komplementärer Medizin und Pege

(KMP) zu beraten, darunter auch zu sL. Äußere Anwendungen (ÄA) und

Akupressur (AP), als Maßnahmen, die auch für die Selbstfürsorge gee-

ignet sind, werden häug von Pegefachpersonen angewandt. Ziel war

es, komplementäre pegerische Maßnahmen bei sL zu identizieren und

hierzu zu beraten.

Methods: Ein 2-stuges Delphi-Verfahren auf Basis einer

Literaturrecherche mit n=8 PegeexpertInnen und n=4 ÄrztInnen,

mit Expertise in komplementären, naturheilkundlichen Verfahren

wurde durchgeführt. Bewertungskriterien zur Aufnahme in den KMP

Maßnahmen-Katalog waren: Wirksamkeit, Sicherheit, leicht anzuwenden

für PatientInnen und/oder Angehörige, kostengünstig.

Result: Es wurden 5 KMP Maßnahmen identiziert. In CCC-Integrativ

wurden von den n=603 Ratsuchenden n=64 (11%) zu sL beraten. Sie

wurden angeleitet zu: Einreibung mit ätherischen Ölen (n=24), Borago

Essenzwickel (n=19), Akupressur (Magen 40) (n=11), Quarkauage

(n=9), Kohlblattauage (n=3). Schriliche Anleitungen, mit detailliierten

Angaben zur sicheren Umsetzung Zuhause, wurden mitgegeben.

Discussion: Der KMP Maßnahmen-Katalog bot den Beratungsteams eine

Auswahl von KMP Maßnahmen mit höchstmöglicher Evidenz, zu denen

die Ratsuchenden individuell und gezielt beraten wurden. Am häugsten

wurde zu den sehr einfach anzuwendenden Maßnahmen (Einreibungen

und Essenzwickel) beraten.

Conclusion: Komplementäre ÄA könnten sinnvolle therapeutische

Maßnahmen zur Förderung der Selbstfürsorge und Steigerung der

Patientenaktivierung bei sL sein. Onkologisch Erkrankten sollten diese

erapieoptionen angeboten werden.

Disclosure Statement: e authors declare no conict of interest.

347

Komplementäre Äußere Anwendungen bei Hitzewallungen

durch antitumorale, endokrine Therapie

Bettina Noack1; Birgit Kröger1; Elke Kaschdailewitsch1; Andreas Schmitt2;

Lioba Lohmüller1; Jan Valentini1; Stefanie Joos1; Regina Stolz1;

Cornelia Mahler2

1Universiätsklinikum, Institut für Allgemeinmedizin und Interprofessionelle

Versorgung, Tübingen, Deutschland

2Universitätsklinikum, Institut für Gesundheitswissenschaften/

Pegewissenschaften, Tübingen, Deutschland

Background: Onkologisch Erkrankte mit antitumoraler, endokriner

erapie leiden häug unter Hitzewallungen (HW), welche die

Lebensqualität der Betroenen stark einschränken. erapeutische

Optionen sind begrenzt. Laut S3-LL Komplementärmedizin in der

Behandlung von onkologischen PatientInnen (S3 LL KM) „können“

Akupunktur, Cimicifuga racemosa, Mindfulness Based Stress Reduction

und Yoga bei menopausalen Symptomen eingesetzt werden. Die CCC-

Integrativ Studie hatte das Ziel, onkologisch Erkrankte interprofes-

sionell und Evidenz basiert zu komplementärer Medizin und Pege

(KMP) zu beraten, darunter auch zu HW. Äußere Anwendungen (ÄA),

als Maßnahmen, die auch zur Selbstfürsorge geeignet sind, werden häu-

g von Pegefachpersonen angewandt. Ziel war es, komplementären

pegerischen Maßnahmen bei HW zu identizieren und zu beraten.

Methods: Ein 2-stuges Delphi-Verfahren auf der Basis einer

Literaturrecherche mit n=8 PegeexpertInnen und n=4 ÄrztInnen mit

Expertise in komplementären, naturheilkundlichen Verfahren wurde

durchgeführt. Bewertungskriterien zur Aufnahme in den KMP Katalog

waren: Wirksamkeit, Sicherheit, für PatientInnen und/oder Angehörige

leicht anzuwenden, kostengünstig. Die interprofessionellen Beratungen

wurden nach Beratungsanlass ausgewertet.

Result: Von den n=603 Ratsuchenden in CCC-Integrativ wurden

n=75 (12%) zu HW beraten. Ergänzend zur S3 LL KM wurden 5

weitere KMP Maßnahmen empfohlen: Salbei Tee innerlich (n=52), als

Waschung (n=36), Fußbad (n=17), Basenbad Teil- und Vollbad (n=16)

und Akupressur (Leber 3/Perikard 6) (n=51). Schriliche Anleitungen

mit detaillierten Angaben zur sicheren Umsetzung zuhause wurden

mitgegeben.

Discussion: Der KMP Katalog bot den Beratungsteams eine Auswahl

von KMP Maßnahmen mit höchstmöglicher Evidenz, zu denen die

Ratsuchenden individuell, aktivierend und gezielt beraten wurden.

Conclusion: Komplementäre ÄA könnten sinnvolle therapeutische

Maßnahmen zur Förderung der Selbstfürsorge und Steigerung der

Patientenaktivierung bei HW sein.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 153

399

Management of CAR T-cell therapy in pediatrics - nursing

recommendations for inpatient care

Julia Mattarei

Charité Universitätsmedizin, Berlin, Deutschland

Background: Chimeric antigen receptor T-cell therapy (CAR T-cell ther-

apy) is a potentially curative immunotherapy for pediatric patients with

relapsed or refractory B-ALL. However, life-threatening adverse events

may occur. Accurate nursing assessment leads to early recognition of

adverse events and may prevent the occurrence of complications. e aim

of this literature review is to provide evidence-based recommendations in

the management of CAR T-cell therapy for nurses. e research question

is: How can CAR T-cell therapy at a pediatric stem cell transplant ward be

designed in an evidence-based manner from a nursing perspective?

Methods: A literature search of 12 databases was conducted. e results

were considered with the inclusion of the nursing process.

Result: Six publications were included. Seven nursing recommendations

for the treatment of pediatric patients were derived from the results.

e focus is on education, database assessment, Lymphodepleting con-

ditioning, CAR T-cell infusion, side eect management and discharge

management.

Discussion: e included publications are largely based on experiences of

CAR T-cell centers and consensus opinions. In the absence of randomized

data, no strengths of evidence were assigned to the recommendations. e

importance of assessments was elaborated by linking them to the nurs-

ing process. Little evidence was found on counseling, illness experience

andcoping.

Conclusion: ere is a high degree of consensus in the selected literature on

the recommendations derived. eir application contributes to safe patient

care. ere is a need for research on nursing problems and their treatment

in the daily care of pediatric patients receiving CAR T-cell therapy.

Disclosure Statement: e authors declare no conict of interest.

469

Die Identikation pegerischer Beratungs- und

Unterstützungsbedarfe durch ein elektronisches,

multiprofessionelles Screening

Timo Gottlieb; Sarah Kühnel

Universitätsmedizin Essen, Essen, Deutschland

Background: Am Universitätsklinikum Essen ndet eine elektronische

Bedarfserhebung zu psychoonkologischen, palliativmedizinischen und

pegerischen Bedarfen statt. Die Befragung der Patient*innen ndet

sowohl im ambulanten, als auch im stationären Setting statt. Dieses Tool

wird bei allen onkologischen Patient*innen zur möglichen Anpassung der

Versorgungsstruktur genutzt. Das Tool wird EPOS genannt.

Methods: Ab Oktober 2022 werden die durchgeführten Screenings nach

einem vorgegebenen Algorithmus ausgewertet und ergeben ein Scoring.

Dieses Scoring wird täglich von einer multiprofessionellen Gruppe der

beteiligten Berufsgruppen ausgewertet. Daraus werden notwendige

Versorgungsalgorithmen abgeleitet und Maßnahmen eingeleitet.

Result: Im Rahmen der strukturierten Erfassung und Auswertung der

Ergebnisse seit Oktober 2022 wurden ca. 7.000 Screenings durchgeführt.

Auf dieser Basis konnten bereits zahlreiche Versorgungsstrukturen

angepasst werden. Dabei können auch bestimmte Regelmäßigkeiten im

Screening einzelnen Fachabteilungen des Universitätsklinikums zugeord-

net werden. Für die onkologische Fachpege können hier spezische

Beratungsbedarfe identiziert und Häufungen von Nebenwirkungen

einer Tumortherapie ausgewertet werden. Beispielha seien hier

Mangelernährung und Polyneuropathie genannt.

Discussion: Neben den bisher vor allem positiven Auswirkungen der

Anwendung des Screenings muss noch evaluiert werden, ob das Screening

in der aktuellen Form ausreichend ist, um alle Patient*innen zu identi-

zieren. Zudem muss noch strukturierter evaluiert werden, inwieweit das

Screening zielgerichtet eingesetzt werden kann.

Conclusion: Das EPOS-Screening bietet die Möglichkeit, den Bedarf für ver-

schiedene Berufsgruppen zu identizieren. Erste Ergebnisse konnten insbe-

sondere in den Bereichen KMT, Gynäkologie und soliden Onkologie einen

erhöhten Bedarf messen. Es wird weiter daran gearbeitet, das Screening

strukturiert auszuwerten und weitere wissenschaliche Daten zu erheben.

Disclosure Statement: e authors declare no conict of interest.

510

Erleben und Gestalten des Behandlungsprozesses der

allogenen Stammzelltransplantation aus der Sicht von

Pegefachpersonen

Sarah Kühnel

Universität Witten/Herdecke, Department für Pegewissenschaft, Fakultät für

Gesundheit, Witten, Deutschland

Background: Die pegerischen Versorgungsschwerpunkte in der

erapie der allogenen Stammzelltransplantation sind vielfältig und

komplex. Die Perspektive der Pegenden, die in diesem besonderen

erapiefeld der Hämatologie tägig sind, wurde in wissenschalichen

Arbeiten kaum fokussiert. Das Ziel der Arbeit ist die Erfassung und

Darstellung des Erlebens und Gestaltens des Behandlungsprozesses bei

allogener Stammzelltransplantation aus Sicht von Pegenden.

Methods: Zur Beantwortung der Fragestellung wird ein qualitatives Design

genutzt. Es werden semistrukturierte, leitfadengestützte Interviews mit

Pegenden, die in der erapie der allogenen Stammzelltransplantation

tätig sind, geführt. Die Auswertung erfolgt mittels der Grounded-eory

nach Strauss und Corbin.

Result: Erwartet werden Ergebnisse, die Hinweise auf die vielfältigen

Aufgabenschwerpunkte der in der Versorgung tätigen Pegefachpersonen

und ihrem persönlichen Erleben dieser Arbeiten geben. Erste Ergebnisse

zeigen, dass die pegerische Arbeit sich durch verschiedene Faktoren als

sehr intensiv darstellt.

Discussion: Die Pegenden nehmen eine essenzielle Rolle in der Begleitung

während der stationären Phase und der Vorbereitung ihrer Patient:innen

und Angehörigen, auf das Leben nach der Stammzelltransplantation

ein. Diese Erkenntnisse geben Hinweise auf die Vielfältigkeit der von

den Pegenden geforderten Kompetenzen, u.a. die Edukation und den

Beziehungsauau. Es zeigt sich, dass eine individuelle und ganzheitliche

Sicht auf die Patient:innen unerlässlich ist.

Conclusion: Bisher besteht wenig wissenschaliche Fokussierung auf die

pegerische Versorgung während der allogenen Stammzelltransplantation.

Erste Ergebnisse dieser Arbeit zeigen jedoch auf, wie intensiv die pegeri-

sche Begleitung der Patient:innen in der erapie ist. Diese Arbeit kann in

der Praxis dazu genutzt werden, ein besseres Verständnis für pegerisches

Handeln zu generieren.

Disclosure Statement: e authors declare no conict of interest.

626

Fatigue - an underestimated symptom in pediatric oncology

Tobias Hemicker

Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz,

Deutschland

Background: Whilst becoming a specialist nurse for pediatric oncology

you learn a lot about dierent symptoms, which can occur during and

aer treatment of pediatric cancer. Fatigue as one of them made me think-

ing: If there is fatigue amongst pediatric patients, how could you measure

it? What do my follow nurses know about fatigue. Which possible ways of

supporting treatment do they know and use?

Methods: A literature research was undertaken aiming for the percep-

tion of the topic “fatigue amongst pediatric cancer”. In addition, a survey

under fellow pediatric nurses working in pediatric oncology was carried

out asking for their knowledge and actions concerning fatigue. As last

component, a comparison between dierent assessment tools has been

accomplished.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts154

Result: All by the research found data showed that there could be found

fatigue amongst pediatric patients. What all found literature also showed

was that there is not jet much research done concerning fatigue in pediat-

ric oncology. e survey showed that all fellow nurses knew about fatigue

and possible ways to treat it. e search for an assessment, which is suita-

ble for pediatric patients from age 0 to 18, revealed three. In comparison,

they are more or less suitable in their construction for each age group.

Discussion: Commonly fatigue is listed as one of the most common

symptoms in patients with cancer. Surprisingly there could not be found a

prove on an implementation of an assessment in pediatric oncology.

Conclusion: ere is fatigue in pediatric patients, which are undergoing

or have undergone cancer treatment. Sadly, fatigue is not really a topic

during the daily work.

Nurses know about fatigue and possible ways to act against its possible

consequences. Intuitively nurses act against fatigue and try to motivate

and agitate their patients.

Each of the three found assessments has its strengths and weaknesses. It

has to be distinguished whether you want to use an assessment which is

applicable for the whole age group, that can be found in pediatric oncol-

ogy or if you want to use an assessment which is more specic for an

specic age group.

Disclosure Statement: e authors declare no conict of interest.

713

Erhebung des psychoonkologischen Unterstützungsbedarfs

durch die onkologische Pege: Chance für

Kompetenzzuwachs oder lästige Bürokratie?

Johannes Bösche1; Daniela Breitschuh2

1Uniklinik Köln, Zentrale Onkologische Fachpege, Pegedirektion, Klinik 1 für

Innere Medizin, Köln, Deutschland

2Uniklinik Köln, Klinische Psychoonkologie, Klinik 1 für Innere Medizin, Köln,

Deutschland

Background: Die DKG-Zertizierungsvorgaben für die Psychoonkologie

sehen ein ächendeckendes Screening vor. An der Uniklinik Köln

übernimmt neuerdings die onkologische Pege die Durchführung des

psychoonkologischen Screenings (POS) im stationären Bereich und leitet

selbständig die psychoonkologische Versorgung in die Wege. Dadurch

werden deutlich mehr Patient:innen mit einem Unterstützungsbedarf

identiziert. Erleben die Pegenden diese neue Aufgabe als

Kompetenzerweiterung (1) oder als zusätzliche Arbeitsbelastung?

Methods: Zunächst wurden zwei Expert:innen Interviews mit Pegenden

geführt, die mit dem Distress-ermometer arbeiten. Hierzu wurde

ein teilstandardisierter Leitfaden genutzt, der mithilfe der Erkenntnisse

aus der Implementierungsphase entwickelt wurde. Weiterhin sind

Fokusgruppen und Einzelinterviews mit Pegenden verschiedener

Bereiche sowie pegerischen Leitungen geplant. Es folgt eine Auswertung

auf Basis der qualitativen Inhaltsanalyse nach Mayring.

Result: Erste Ergebnisse deuten darauf hin, dass Pegende die Übernahme

des Screenings begrüßen. Die Optimierung der Prozesse (weniger

Schnittstellen, schnellere Kontaktaufnahme, KIS) wird positiv bewertet. Die

Mehrarbeit wird als gering erachtet. Zudem erleichtert die Durchführung

des Screenings den Pegenden, sensible emen anzusprechen.

Discussion: Die Ergebnisse geben Hinweise, dass mit der Übernahme

des POS eine Komptenzerweiterung verbunden ist. Hierbei erscheint

die eigenständige Veranlassung der psychoonkologischen Betreuung auf

Basis des Assessments als entscheidender Faktor.

Conclusion: Die aktive Beteiligung der Pege führt zu einer Verbesserung

des POS. Pegende leisten somit einen wichtigen Beitrag zur psychoonkol-

ogischen Versorgung. Die neu gewonnene Handlungsfähigkeit und

daraus resultierende Wirksamkeit führt zu einem Kompetenzzuwachs,

der positiv erlebt wird.

Indication of source:

1 Olbrich, C. (1999): Pegekompetenz. Verlag Hans Huber: Bern.

Disclosure Statement: e authors declare no conict of interest.

780

Komplementäre Pege als Ergänzung der supportiven

Therapie in der Onkologie – eine Querschnittsstudie

Sandra Liebscher-Koch1; Judith Büntzel2; Maren Schürmann1

1Universitätsmedizin Göttingen, Göttingen, Deutschland

2Klinik für Hämatologie und Medizinische Onkologie, Göttingen, Deutschland

Hintergrund: Die komplementäre Pege (KP) ist seit Jahren fester

Bestandteil der Patient*innenversorgung an der Universitätsmedizin

Göttingen. Ein Team aus speziell ausgebildeten Pegefachpersonen

betreut im Rahmen eines Konsildienstes die Patient*innen (Pat) und

schult medizinisches Personal.

Methodik: Durchgeführte Konsile wurden über einen denierten

Zeitraum anonym erfasst. Daten zu Diagnose, erapieziel (kurativ/pal-

liativ), Pegeproblem, komplementäre Methode sowie komplementärer

Maßnahme und Zeitaufwand wurden dokumentiert.

Ergebnisse: Insgesamt wurden 99 Konsile erfasst. 23 der konsultierten Pat

waren männlich, 76 weiblich. Das mediane Alter betrug 61 Jahre (22-93

Jahre). Am häugsten erfolgte eine Beratung von Pat mit hämatologischen

Neoplasien (22/99 Pat) und gastroenterologischen (33/99 Pat) Tumoren.

Es wurden insgesamt 21 verschiedene Pegeprobleme dokumentiert.

Am häugsten wurden die Pegeprobleme Schmerz (20,4%, 30/99 Pat),

Unruhe/Angst (19.1%, 28/99 Pat), psychische Probleme/ depressive

Verstimmung (8,2%, 12/99 Pat), Lymphödem und Verdauungsprobleme

(je 7,8, 11/99 Pat) dokumentiert. Insgesamt wurden sieben Methoden

beschrieben (Aromapege, Auage/Wickel, Beratung, Einreibung,

Gespräch, Heiltee, rhythmische Einreibung). Insgesamt erhielten 99 Pat

146 Interventionen. Am häugsten wurden die Aromatherapie (50,7%,

74/146) und die rhythmische Einreibung (32,9%, 48/146 Pat) angewandt.

Diskussion: Die komplementäre Pege wird konsiliarisch vor allem bei

Schmerzen und psychischer bzw. seelischer Belastung angefordert. Als

Methoden sind die Aromatherapie und rhythmische Einreibung am

präsentesten. Der zeitliche Aufwand zur Schulung von Angehörigen oder

des direkt betreuenden Pegefachpersonal ist mit i. d. R. ca. 15 min gut in

den klinischen Alltag zu integrieren.

Schlussfolgerung: Komplementäre Pegeberatung im onkologischen Setting ist

praktikabel, gut durchführbar und eine sinnvolle Ergänzung zur onkologischen

Supportivtherapie.

Disclosure Statement: e authors declare no conict of interest.

819

”Was sieben Jahre währt, ist nie verkehrt“

Susanne Blöß1; Aneta Smuda2; Sandra Juhnke2; Mathias Lier2;

Lena Reckermann2; Christine Reichard2

1Medizinische Hochschule Hannover, KMT-Ambulanz OE 6863, Hannover,

Deutschland

2Medizinische Hochschule Hannover, Hannover, Deutschland

Background: 2016 wurde der Onkologisch Pegerische Konsiliardienst

(OPK) gegründet. Die onkologisch Fachpegenden des OPK bieten eine

Mitbetreuung während des stationären Aufenthaltes in der Medizinischen

Hochschule Hannover an. Zusätzlich werden in unterschiedlichen

Schwerpunktambulanzen ambulante Patient: innen versorgt. Sowohl

in den Ambulanzen, als auch auf den Stationen der MHH beraten die

Fachpegenden Patient:innen und deren Zugehörige zu therapiebed-

ingten Nebenwirkungen und Symptomen. Die Beratungsanfragen sind

in den letzten Jahren kontinuierlich gestiegen. Die Diagnose Krebs stellt

ein einschneidendes Lebensereignis dar. Dementsprechend ist es wichtig,

dass die Patient:innen das erapiegeschehen nachvollziehen und aktiv

mitgestalten können. Die Beratung erfolgt zum einen symptomorientiert,

umfasst aber auch den psychosozialen Kontext und die Lebenswelt der

Patient: innen.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 155

Methods: Die Daten der Patient:innenbefragung des OPK wurden von

Mai bis Dezember 2020 erhoben. Das Befragungsinstrument wurde in

gedruckter Form den Patient:innen ausgehändigt. Der Rücklauf erfolgte

über die Mitarbeiter:innen der Schwerpunktambulanzen.

Result: Neben Fragen zur Zufriedenheit, wurde auch das

Symptommanagement evaluiert und die Weiterleitung an unterstützende

Dienste erfragt. Die Freitextbereiche konnten für Verbesserungsbedarfe

und individuelle emen genutzt werden.

Discussion: Die Entwicklung des Onkologisch Pegerischen

Konsiliardienstes (OPK) in der Medizinischen Hochschule Hannover

(MHH).

Conclusion: Komplexe Gesundheitsstörungen sowie moderne onkol-

ogische Tumortherapien haben unterschiedliche erapieverläufe zur

Folge. Die steigende Anzahl der Beratungsanfragen zeigt den erhöhten

Pegeberatungsbedarf der Betroenen sowie der Zu- und Angehörigen.

In der Auswertung der Patient:innenbefragung wird deutlich, dass die

Betroenen das Pegeberatungsangebot außerordentlich positiv bewer-

ten und davon persönlich protieren.

Disclosure Statement: e authors declare no conict of interest.

930

Körper er lebens orientierte Pegeinterventionen in der

Begleitung von Frauen mit fortgeschrittenem Brustkrebs

in der letzten Lebensphase

Sara Marquard

Universität Osnabrück, Osnabrück, Deutschland

Background: Über die spezischen Bedürfnisse sowie psychosozialen

Belastungen von Frauen mit einer heilbaren Brustkrebserkrankung ist

viel bekannt. Dagegen ist nicht dierenziert und empirisch belastbar

untersucht, wie Frauen mit einer fortgeschrittenen Brustkrebserkrankung

in der letzten Lebensphase ihre körperlichen Beeinträchtigungen erleben

und wie spezialisierte Pegefachpersonen angemessen darauf reagieren

können.

Methods: Um die subjektiven Vorstellungen von körperlichen

Veränderungsprozessen und deren Auswirkungen auf das Alltags(er)

leben von unheilbar an Brustkrebs erkrankten Frauen zu erfassen, wurde

die Grounded-eory-Methodologie nach dem Vorgehen von Strauss

und Corbin gewählt. Insgesamt wurden 22 leitfadengestützte Interviews

mit Frauen in deren Häuslichkeit, im Hospiz sowie in akutstationärer

Versorgung geführt.

Result: Das zentrale Phänomen Gezeichnet sein zeigt sich bei allen Frauen

in einem veränderten Aussehen, spürbaren Veränderungen sowie einem

zunehmenden körperlichen Verfall. Ursache dafür sind insbesondere

die zum Teil Jahre andauernden palliativen erapien und damit ver-

bundene massive Nebenwirkungen sowie ein zunehmender Progress

der Erkrankung, was zusammengenommen unumkehrbar zu einer

Verschlechterung des körperlichen Bendens führt.

Discussion: Um die praktische Ebene der Körperarbeit erreichen zu kön-

nen sind pegerische Bildungsprozesse erforderlich. Pegefachpersonen

müssen in leiblicher Kommunikation sensibilisiert und geschult werden,

Wahrnehmungskompetenzen sollten stärker Berücksichtigung nden.

Conclusion: Dann kann dem Gezeichnet sein mit körpererle-

bensorientierten Pegeinterventionen begegnet werden. Vor dem

Hintergrund der Erfahrungen der interviewten Frauen lassen sich fol-

gende Pegehandlungen ableiten: Frauen in der Versprachlichung ihres

Körpererlebens ermutigen, über die letzte Lebenszeit sprechen, körperor-

ientierte Routineangebote kritisch reketieren. Dies kann dazu beitragen,

das Körpererleben positiv zu beeinussen.

Disclosure Statement: e authors declare no conict of interest.

Other Topics

Advancing patient involvement in clinical research - The

Patient Advisory Board of the Study Center of the German

Society of Surgery

Magdalena Holze1,2; Sophia Vogel-Adigozalov2; Solveig Tenckho2;

Maximilian Joos1,2; Rosa Klotz1,2; Patient Advisory Board (Sdgc)2

1Universitätsklinikum Heidelberg, Klinik für Allgemein-, Viszeral- und

Transplantationschirurgie, Heidelberg, Deutschland

2Studienzentrum der Deutschen Gesellschaft für Chirurgie, Heidelberg,

Deutschland

Background: e perspective of patients has historically not been heard

in both clinical research and care. Currently, just few scientic institu-

tions provide sustainable mechanisms for patient involvement in research

projects. Nevertheless, patient involvement has gained importance and is

now advocated not solely by patient representatives and researchers, but

also demanded by funders. To meet these requirements and to strengthen

active patient involvement the Patient Advisory Board (PAB) of the

Study Center of the German Society of Surgery (SDGC) was founded at

Heidelberg University Hospital in 2021.

Methods: e PAB comprises 16 members including patients undergo-

ing major surgery, their relatives, and representatives of patient support

groups, such as ILCO, and AdP. e PAB has developed and adopted

its own bylaws and meets regularly. PAB activities include prioritizing

research topics, advising on grant applications, generating trial docu-

ments and publications in lay terms, and involvement in study design and

study-related committees.

Result: As of August 2023, the PAB has conducted a total of 17 meetings

and advised 20 study ideas from researchers nationwide for funding appli-

cations. 6 PAB representatives have been integrated into trial committees,

contributing actively to the conduct of these trials. Besides, 2 own BMBF-

funded projects were initiated in cooperation with the PAB: a systematic

review examining the current status of patient involvement in surgical

trials and a conceptional phase aimed at designing a multicenter RCT on

prehabilitation in colorectal cancer patients.

Discussion: Institutions like the PAB play a pivotal role in advancing patient

involvement, enabling researchers to actively incorporate patient experience.

Conclusion: e PAB is one of the rst patient advisory boards in

Germany. Its high level of activity and advocacy by patients, research-

ers and funders demonstrates the need for such institutions within the

German research landscape.

Disclosure Statement: e authors declare no conict of interest.

153

Establishment of a central registry as an option for improved

access to clinical trials at the Krukenberg Cancer Center Halle

(KKH)

Lara-Marie Schulze1; Hichem Ben Hamed2; Sandra Ehlert1; Federica Bini3;

Corinna Kistner2; Haifa Al-Ali1; Daniel Tiller2; Jan Christoph2,3;

Susann Schulze1

1Krukenberg Cancer Center Halle, University Medicine Halle, Halle (Saale),

Deutschland

2Data Integration Center, University Medicine Halle, Halle (Saale), Deutschland

3AG (Bio-)Medical Data Science, Martin-Luther-University Halle-Wittenberg,

Halle (Saale), Deutschland

Background: In oncology, it is important to provide patients with a

comprehensive oer of clinical trials. erapy options are becoming increas-

ingly specic, meaning that the inclusion criteria for clinical studies are

becoming more restrictive and the study designs more complex. In order to

provide appropriate trials to all patients, a complete overview of available trials

is needed for treating physicians. [1] We show that this can be implemented by

creating an electronic database at the Krukenberg Cancer Center Halle (KKH).

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts156

Methods: With the Research Electronic Data Capture (REDCap) a collec-

tion with meta data of all available clincical studies at the location is build.

Its data can be displayed by Reports within REDCap. More complex Queries

are shown in the collaboration platform Conuence using Structured

Query Language (SQL). Compliant with data protection requirements, the

data is stored on internal servers of the University Medicine Halle (Saale).

Results: e trial registry was built from April 2022 to May 2023. To enter

and store data consistently and centrally, study attributes were integrated

in forms. Analyses are presented as tables. Besides three REDCap reports

there are further 29 at Conuence. e data are available and daily updated.

Discussion: A user friendly electronic trial registry for the KKH was suc-

cessfully implemented. While providing an enhanced workow, the set up

of the database requires high eort. Computer science skills are necessary

to manage complex reporting structures. us, close cooperation of the

KKH and the Data Integration Center is essential.

Conclusion: Digitization in the healthcare sector, requires close collabo-

ration between a Data Integration Center and medical sta. In this way,

process optimization can be achieved. An extension of the project to

external partners would be desirable.

Indication of source:

1 Unger JM, et al. American Society of Clinical Oncology Educational Book36

(May 19, 2016) 185–198. DOI:10.1200/EDBK_156686.

Disclosure Statement: e authors declare no conict of interest.

207

Evaluation and implementation of multidisciplinary and

standardized long-term follow-up care for adult survivors of

childhood cancer in Germany – A prospective, multi-centric,

nationwide study (LE-Na)

Chirine Cytera1; Katja Baust2; Anja Borgmann-Staudt3;

Gabriele Calaminus2; Katharina Egger-Heidrich4; Jörg Faber5; Desiree

Grabow6; Teresa-Veronika Halbsguth7; Ann-Kristin Kock-Schoppenhauer8;

Inke König9; Sebastian Michaelis10; Anke Neumann8; Alexander Puzik11;

Sonja Schuster12; Marianne Sinn13; Thorsten Langer1; Judith Gebauer14

1Paediatric Haematology and Oncology, University Hospital of Schleswig-

Holstein, Campus Luebeck, Lübeck, Deutschland

2Department for Paediatric Haematology/Oncology, University Hospital Bonn,

Bonn, Deutschland

3Department of Paediatric Oncology and Haematology, Charité-

Universitätsmedizin Berlin Germany, Corporate Member of Freie Universität

Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin,

Deutschland

4Department of Internal Medicine I, University Hospital Carl Gustav Carus,

Dresden, Dresden, Deutschland

5Department of Pediatric Hematology, Oncology, and Hemostaseology,

Center for Pediatric and Adolescent Medicine, University Medical Center of the

Johannes Gutenberg-University Mainz, Mainz, Deutschland

6Division of Childhood Cancer Epidemiology / German Childhood Cancer

Registry, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI),

University Medical Centre of the Johannes Gutenberg University Mainz, Mainz,

Mainz, Deutschland

7Medical Clinic II, Haematology and Oncology, University Hospital Frankfurt am

Main, Frankfurt am Main, Deutschland

8IT Center for Clinical Research, University of Luebeck, Lübeck, Deutschland

9Institute of Medical Biometry and Statistics, University of Luebeck, University

Hospital of Schleswig-Holstein, Campus Luebeck, Lübeck, Deutschland

10Department of Paediatric Oncology and Haematology, University Hospital

Tübingen, Tübingen, Deutschland

11Division of Paediatric Haematology and Oncology, Department of Pediatrics

and Adolescent Medicine, Medical Center, Faculty of Medicine, University of

Freiburg, Freiburg, Deutschland

12Department of Paediatric Haematology and Oncology, University Hospital

Erlangen, Erlangen, Deutschland

13II. Department of Medicine, University Medical Center Hamburg-Eppendorf,

Hamburg, Deutschland

14Department of Internal Medicine I, University Hospital of Schleswig-Holstein,

Campus Luebeck, Lübeck, Deutschland

Background: Late eects can occur years to decades aer cancer ther-

apy, resulting in morbidity and reduced health-related quality of life

(HRQOL) in cancer survivors. Clinical long-term follow-up (LTFU) ena-

bles timely diagnosis and treatment of these sequelae. So far, only a minor-

ity of German childhood cancer survivors (CCS) regularly visit LTFU care

facilities.

erefore, this study aims to: 1. implement and/or improve LTFU care

structures for adult CCS in Germany, 2. inform former patients about late

eects and LTFU care centers, 3. prospectively assess the prevalence of

chronic health conditions in this cohort and document them in a com-

mon research database 4. establish a clinical long-term follow-up cohort

of adult CCS in Germany.

Methods: Within ve years, over 5000 CCS will be addressed and - follow-

ing their interest - recruited and treated in 10 LTFU centers in Germany.

Study participants are either invited by the German Childhood Cancer

Registry, transitioned from the local pediatric care unit, or contact the

study centers by themselves. Patients are assigned to one of three dierent

risk groups based on their cancer treatment exposure and receive stan-

dardized follow-up care.

Primary study endpoints are satisfaction with the LTFU care oer and

improvement of health-related self-ecacy and will be assessed at two

time points with an interval of three years. Furthermore, an evaluation of

the implemented LTFU care will be enabled by a wait list control group:

e intervention group receives LTFU care as soon as possible. ey com-

plete questionnaires before their rst visit and one year aer. e waiting

control group completes the questionnaires at the initial timepoint and

one year later. ey receive the same intervention aerwards.

All study ndings are documented in a standardized database.

Results and Conclusion: By oering standardized LTFU care to CCS in

Germany that have not received LTFU yet, the LE-Na study expects to

improve nationwide LTFU care and therewith patient’s satisfaction with

the LTFU care oer as well as their HRQOL.

Disclosure Statement: e authors declare no conict of interest.

208

Evaluating the eect of home parental nutrition in cancer

patients using the bioelectrical impedance analysis

Jan Simon1; Margaret Sommer2; Raika Mühlberg2; Rebecca Klindworth2;

Luzia Valentini1

1Hochschule Neubrandenburg, University of Applied Sciences,

Neubrandenburg, Deutschland

2Elb-Apotheke, Hamburg, Deutschland

Purpose: Few studies show the eect of home parenteral nutrition (HPN)

assessed by bioelectrical impedance analysis (BIA), a validated method for

analyzing body composition. e objective of this mixed-method study

was to evaluate body composition, with a special focus on the functional

parameter phase angle, in cancer patients over 2 months aer starting

supportive HPN.

Methods: Adult cancer patients receiving supportive HPN with or with-

out anticancer treatments in care of the Elb-Apotheke (Hamburg) were

included between July and September 2022. Patients were assessed at start

of HPN and aer 30 and 60 days. Assessment included body composi-

tion (BIA seca mBCA525, Nutriguard-MS), anthropometric and clinic-

oncological characteristics. Aer 60 days, semi-structured interviews

were conducted with 5 patients.

Results: Overall, 14 patients (71,4% men) were examined (60±16 years,

body mass index (BMI): 21.5±4.0 kg/m²). Cancer localization was mostly

gastrointestinal (64.3%). Phase angle did not change over time (4.8±1.1° vs.

5.0±0.9°, p=0.406), but body weight, BMI, fat-free mass index and skeletal

muscle mass improved signicantly (p<0.05). Interviewed patients showed

a better understanding of HPN through the presentation of BIA results.

Discussion: e results are line with two other studies with higher sample

sizes and longer observation time (1, 2). e insignicant eects on phase

angle might be due to anticancer treatment (2).

Conclusion: Two months of HPN resulted in improved body weight

and body composition but without signicant eect on phase angle.

Discussing the BIA results with patients can lead to a better understand-

ing of HPN and possibly better adherence.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 157

References:

1. Cotogni P, Monge T, Fadda M, De Francesco A. Bioelectrical impedance

analysis for monitoring cancer patients receiving chemotherapy and home

parenteral nutrition. BMC Cancer. 2018;18(1):990.

2. Pelzer U, Arnold D, Goevercin M, Stieler J, Doerken B, Riess H, et al.

Parenteral nutrition support for patients with pancreatic cancer. Results of a

phase II study. BMC Cancer. 2010;10(1):86.

Disclosure Statement: e authors declare no conict of interest.

211

Benets of the Introduction of a Monitoring Program and

Field Crew Service in Cancer Registration in Rhineland-

Palatinate

Petra Plachky; Hans Christian Lange; Diana Bergner; Sarah Franz;

Christina Justenhoven; Julia Gildemeister

Cancer Registry of Rhineland-Palatinate in the Institute for Digital Health Data

RLP gGmbH, Mainz, Deutschland

Background: Reporting of cancer diagnoses, treatment and follow-up to

clinical cancer registries is mandatory in Germany. e datasets of cancer

registries are used for quality assessment and improvement of oncological

care. ese investigations depend on data quality, which is restricted by

data ow to cancer registries. To solve this issue, the cancer registry in

Rhineland-Palatinate established a monitoring program and a eld ser-

vice. e monitoring program comprises systematic evaluation of onco-

logical facilities regarding number and quality of reports. Deviationists

are contacted personally to remind them of the reporting obligation and

to oer support by the eld service. e mission of this service is the sup-

port of medical facilities regarding reporting to the cancer registry or indi-

vidual training.

Methods: e success of both initiatives was measured by the number

of newly reporting facilities and the number of incoming reports in

correlation with these initiatives. In addition, the number of patients,

that were only notied due to these eorts, was calculated. Our anal-

yses were done by R and based on the dataset of the cancer registry of

Rhineland-Palatinate.

Result: Our initiatives showed considerable success with > 120 institu-

tions starting to report to the cancer registry, > 80,000 reports transmitted

by the eld service and > 7,000 patients, which were only notied due to

these special eorts.

Discussion: e monitoring program and the eld service impressively

improved the data quality of the cancer registry of Rhineland-Palatinate.

Beside the individual success of both initiatives, particularly, their inter-

action contributed to the observed quality intensication. We assume that

the personal contact including admonition (monitoring program) and

support (eld service) is the basis of this success.

Conclusion: e herein reported results demonstrate that monitoring

programs and a eld crew service are crucial for quality of data and subse-

quent analyses in cancer registries.

Disclosure Statement: e authors declare no conict of interest.

215

What burdens and resources do family members of cancer

patients have?

Melanie Jagla-Franke1,2; Merle Nathalie Schilling3; Gabriele Helga Franke2

1Hochschule Neubrandenburg, Neubrandenburg, Deutschland

2Hochschule Magdeburg-Stendal, Stendal, Deutschland

3Westküstenklinikum Heide, Heide, Deutschland

Background: Cancer aects not only the patients, but also their family

members [1]. In recent years has research interest focused not only on

patients but also on relatives. e study aimed to look at psychosocial

aspects of relatives.

Methods: 219 relatives of cancer patients (43.7 ±13.8 years, 52.1% female)

took part in the study. e Distress-ermometer [DT, 2] and the Mini-

SCL [3] were used to assess psychological distress, the Essen Coping

Questionnaire [4] was used as well as the Oslo Social Support Scale [5].

Result: Relatives of cancer patients showed higher values in the DT

(p<.0001, d=0.52) than the comparison sample [2]. ey also showed

mild distress in three out of four Mini-SCL-scales [3]. Compared to [5],

they described lower social support (p=.042, d=0.16). With regard to cop-

ing strategies, only comparative data from parents of children with cog-

nitive impairments (CI; n=118) are available. Relatives of cancer patients

described lower mean values for eight of the nine scales, with small to

large eect sizes.

Discussion: As described in the literature, cancer had an inuence on

the relatives in this sample as well. ey showed distress, a lack of social

support and fewer maladaptive but also less adaptive coping strategies

compared to parents with children with CI.

Conclusion: Relatives are an important resource for cancer patients; sup-

port is necessary.

Indication of source: (Optional, bitte löschen Sie diesen Absatz, wenn Sie keine

Quellenangaben haben):

References:

1 Zimmermann T. (2022). Partnerschaliche und familiäre Aspekte bei

Krebserkrankungen. Bundesgesundheitsbl, 65:446–452.

2 Mehnert A. et al. (2006). Die deutsche Version des NCCN Distress-

ermometers. ZPPP, 54:213–223.

3 Franke GH. (2017). Mini-Symptom-Checklist. Göttingen: Hogrefe.

4 Franke GH & Jagla M. (2016). Essen Coping Questionnaire. www.

psychometrikon.de.

5 Kocalevent R-D et al. (2018). Social support in the general population:

standardization of the Oslo social support scale (OSSS-3). BMC Psychology,

6:31.

Disclosure Statement: e authors declare no conict of interest.

219

Comparison of quality indicators between certied and

non-certied institutions based on data of the cancer registry

of Rhineland-Palatinate

Stefanie Schulz1; Hans Christian Lange2; Katharina Emrich2;

Christina Justenhoven2

1Onkologische Gemeinschaftspraxis Dres. Schulz, Bad Kreuznach, Deutschland

2Krebsregister Rheinland-Pfalz im Institut für digitale Gesundheitsdaten RLP

gGmbH, Mainz, Deutschland

Background: Publication of the results of the WiZen study initiated

a debate about quality of treatment in centers certied by the German

Cancer Society (Deutsche Krebsgesellscha, DKG) vs. non-certied insti-

tutions. We aimed to gain more information on this subject in Rhineland-

Palatinate and initiated a comparison based on quality indicators (QIs).

QIs are subject to S3-guidelines and represent an appropriate measure for

quality of treatment.

Methods: is study was based on data of the cancer registry of Rhineland-

Palatinate comprising the years 2016 to 2020. 19 QIs for breast, lung and

colorectal cancer were chosen according to their calculability with respect

to available data in the context of cancer registration in Germany. For each

QI compliance was analyzed for certied centers and non-certied insti-

tutions using the binominal test. e Soware SAS and R were used for

statistical analyses.

Results: e level of compliance of all analyzed QIs was higher in certied

centers compared to non-certied institutions. For 15 of the analyzed 19

QIs this dierence showed statistical signicance (p<0.005).

Discussion: Our results are in line with the assumption that treatment in

certied centers meet the recommendations of S3-guidelines more oen

than in institutions without certicate. One reasons for higher adherence

to guidelines could be a better management of the patients due to a multi-

disciplinary team including tumorboards.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts158

Conclusion: First results on a QI-based comparison in Rhineland-

Palatinate suggest better compliance to S3-guidelines in centers certied

by the German Cancer Society vs. institutions without certicate.

Disclosure Statement: e authors declare no conict of interest.

250

Patient-Centered Cancer Care: A Conceptual Framework

and Actionable Strategies for Comprehensive Cancer Care

Networks

Emily Hickmann; Peggy Richter

Technische Universität Dresden, Dresden, Deutschland

Background: In contemporary healthcare, the concept of patient-centered

care has emerged as a pivotal paradigm shi that redenes the tradi-

tional physician-centric model. Particularly in the context of cancer care,

marked by its intricate nature and emotional impact, there’s a pressing

requirement to rethink how healthcare is delivered. In this context,

Comprehensive Cancer Care Networks (CCCNs) provide a new means

of structuring and providing quality cancer care, recognizing the unique

preferences and needs of each patient. To facilitate this patient-centered

approach in practice and advance care quality, it is essential to establish a

consistent denition and framework of patient-centeredness in a CCCN.

Methods: A systematic meta-review focusing on generic and oncolo-

gy-specic dimensions of patient-centeredness and a survey with key

stakeholders in the CCCN context were conducted.

Result: A denition and framework of patient-centeredness in CCCNs

is presented. e framework comprises eight primary dimensions:

Empowering patients, Engaging and Involving Patients, Treating the

Patient as a Unique Person, Enhancing the erapeutic Relationship,

Enhancing a Patient-Centered Culture, Providing Holistic Care,

Recognizing and Supporting the Caregiver as a Person and Coordinating

Care. Each dimension is supported by corresponding subdimensions and

actionable patient-centered activities.

Discussion: e results provide a comprehensive perspective on the

intricate elements that compose patient-centered care within CCCNs.

is can contribute to an improved and harmonized comprehension

of patient-centeredness in CCCNs, potentially leading to an enhanced

implementation of the concept in practice.

Conclusion: e results presented in this paper aspire to support CCCNs

in establishing a patient-centered environment where patients feel genu-

inely heard, valued, and actively engaged in their own care decisions.

e authors declare no conict of interest. is research was conducted in the

realm of the Joint Action CraNE and is funded by the European Union.

Disclosure Statement: e authors declare no conict of interest.

251

BMS-986158, a potent bromodomain and extraterminal

inhibitor (BETi), as monotherapy and in combination with

ruxolitinib or fedratinib, in intermediate- or high-risk

myelobrosis (MF): results from a phase 1/2 study

Haifa Al-Ali1; Rosa Ayala2; Nieves Lopez3; Adi Shacham Abulaa4;

Maan Alwan5; Costas K. Yannakou6; Indu Raman6; Vincent Ribrag7;

Chung Yew Fong8; Yulia Volchek9; Massimiliano Bonifacio10;

Alessandra Tucci11; Jean-Jacques Kiladjian12; Jésus María Hernández

Rivas13; Blanca Xicoy14; Jean-Christophe Ianotto15; Si Tuen Lee-Hoeich16;

Sharmilla Das17; Bin Wu16; Qian Zhao18; Oriana Esposito19; Yu Liu16;

Zariana Nikolova19; Christopher Tehlirian16; Shodeinde Coker18;

David Lavie20

1Universitätsklinikum Halle, Halle, Deutschland

2Hematology and Hemotherapy Department, Hospital Universitario 12 de

Octubre, CNIO, Complutense University, CIBERONC, Madrid, Spanien

3University Hospital October 12, Madrid, Spanien

4Beilinson - Helen Schneider Comprehensive Women‘s Health Center, Petah

Tikva, Israel

5Perth Blood Institute, West Perth, Australien

6Epworth HealthCare, Melbourne, Australien

7Département d‘Innovation Thérapeutique et d‘Essais Précoces (DITEP), Gustave

Roussy Institute, Villejuif, Frankreich

8Department of Haematology, Austin Health, Heidelberg, Australien

9Department of Hematology, Assaf Harofeh Medical Center, Zerin,

Zerin, Israel

10Department of Medicine, Section of Hematology, Verona University and

Azienda Ospedaliera Universitaria Integrata, Verona, Italien

11Hematology Unit, ASST Spedali Civili di Brescia, Brescia, Italien

12Centre d‘Investigations Cliniques (CIC 1427), Assistance Publique-Hôpitaux de

Paris, Hôpital Saint-Louis, INSERM, Université Paris Cité, Paris, Frankreich

13Department of Medicine, University of Salamanca, Department of

Hematology, Hospital Universitario de Salamanca, Salamanca, Spanien

14Hospital Universitari Germans Trias i Pujol, Barcelona, Spanien

15Centre Hospitalier Universitaire de Brest, Brest, Frankreich

16Bristol Myers Squibb, Cambridge, USA

17Bristol Myers Squibb, Princeton, USA

18Bristol Myers Squibb, Lawrenceville, USA

19Center for Innovation and Translational Research Europe, a Bristol-Myers

Squibb Company, Seville, Spanien

20Hadassah Medical Center, Jerusalem, Israel

Background: BMS-986158 is an orally bioavailable, potent, selective

small-molecule BETi currently evaluated in patients (pts) with MF in the

CA011-023 study (NCT04817007).

Methods: CA011-023 has a dose-escalation phase with BMS-986158 +

ruxolitinib (RUX) in RUX-naive pts (Part 1A) or BMS-986158 + fedrati-

nib (FED) in pts refractory, relapsed, or intolerant to RUX treatment (Tx)

(Part 1B). Planned doses for Part 1A are BMS-986158 2.0, 3.0, and 3.75

mg QD 5d on/2d o and RUX 15 mg BID. Planned doses for Part 1B are

BMS-986158 0.5, 0.75, and 1.25 mg QD 5d on/2d o and FED 400 mg QD.

Result: As of Sep 2, 2022, 23 pts were treated (Part A: 11 [median age

67 y (range, 36–81)]; Part 1B: 12 [69 y (37–77)]). Any grade (G) treat-

ment-related adverse events (TRAEs) occurred in 9 (82%)/9 (75%) pts in

Part 1A/1B. G3/4 TRAEs in Part 1A were thrombocytopenia (n = 5, 45%),

neutropenia, hypertension, and anemia (n = 1 each, 9%). G3/4 TRAEs in

Part 1B were thrombocytopenia, anemia (n = 5 each, 42%), diarrhea, and

blood bilirubin increase (n = 1 each, 8%). DLTs were reported in 2 pts in

Part 1A (both thrombocytopenia with dose reduction of BMS-986158 in

the 2.0 and 3.75 mg groups), and in 3 pts in Part 1B (diarrhea, thrombo-

cytopenia, and elevated bilirubin; all in the 1.25 mg group). Spleen vol-

ume reduction (SVR) was observed at wk 12 in Part 1A and continued to

deepen at wk 24. In Part 1A, 5/6 (83%) pts treated with BMS-986158 (2.0

or 3.0 mg) + RUX met SVR35 at wk 12; and 6/6 (100%) at wk 24. In Part

1B, 0/6 (0%) pts treated with BMS-986158 (0.5 or 0.75 mg) + FED met

SVR35 at wk 12; and 1/3 (33%) at wk 24. Pts in Part 1B vs 1A were treated

at lower BMS-986158 dose levels. JAK2 variant allele frequency analysis

showed reductions in JAK2V617F frequency in Parts 1A (41% max reduc-

tion, n = 7) and 1B (30% max reduction, n = 4).

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 159

Discussion: BMS-986158 with RUX or FED had acceptable and manage-

able safety proles; most TRAEs were G1/2 in severity.

Conclusion: Initial results show that BMS-986158 + RUX produced

robust SVR in pts with MF, with deepening responses beyond wk 12 with

continued Tx.

First published: Ayala R et al. HemaSphere 2023;7[S3]:S213.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

285

Pitfalls in interpreting patient reported outcome (PRO) results

in oncology trials: consequences of insucient data recording

Michael Köhler; Sascha Abbas

Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen (IQWiG), Köln,

Deutschland

Background: To demonstrate methodological aws of PRO documenta-

tion and analysis in clinical trials and the consequences for interpretation.

Methods: Examples from German benet assessments were used to

illustrate the problems of shortened observation periods for PROs (i.e.

European Organisation for Research and Treatment of Cancer Quality of

Life Questionnaires [EORTC QLQ] – Cancer 30 and – Breast Cancer 23)

in breast cancer trials (studies MONARCH 2 and MONARCH plus, com-

paring Abemaciclib + Fulvestrant to Fulvestrant alone). e consequences

for ecacy claims are discussed.

Result: e pharmaceutical company presented time-to-event analysis

of PRO outcomes dened as deterioration of 10 points without subse-

quent improvement. Statistically signicant advantages for Abemaciclib

were reported for several EORTC QLQ scales. However, PROs were only

recorded until end of treatment (e.g. due to disease progression) resulting

in a markedly shorter observation period compared with median over-

all survival time and a shorter observation period in the comparator arm

(73% [MONARCH 2] and 50% [MONARCH plus] compared to the inter-

vention arm). Conclusions can therefore only be drawn for the time until

progression. Due to the shorter observation period, deterioration without

subsequent improvement was potentially easier to achieve in the control

group. is results in a potential bias in favor of the intervention.

Discussion: Shortened and dierent observation periods between treat-

ment arms potentially introduce bias in PRO results. ese shortcomings

severely limit interpretability of study results and provide insucient data

on long-term PRO outcomes that are relevant for patients.

Conclusion: Trial sponsors should collect PRO data for as long as possi-

ble, i.e. until end of the study, to answer the relevant question – especially

from the patients’ perspective – whether patients do better or worse with

a specic drug in the long term.

Disclosure Statement: e authors declare no conict of interest.

322

Medical Quality Programs Department - A centralized unit

for quality assurance in oncology (and other specialties) at a

Swiss hospital for aliated physicians

Nora Woods; Stefan Heuser Preuvot

Klinik Hirslanden, Zürich, Schweiz

Background: e purpose of this abstract is to show under which cir-

cumstances it is possible to certify a medium-sized hospital (335 beds)

in German-speaking Switzerland, which functions predominantly as a

hospital for aliated physicians, as an oncology center according to the

German Cancer Society (DKG).

Methods/Result: e MQP department was launched in 2017, at that

time as the project “Tumorzentrum” at the Klinik Hirslanden in Zurich,

Switzerland. With a team of ve people (Head of Administration, three

Data Managers and a QMB), a breast as well as a prostate cancer center

were the rst to be established and certied according to DKG require-

ments. Since then, the center has been expanded to include a Visceral

Oncology Center (intestine, esophagus and pancreas), a Gynecological

Cancer Center, an Urooncology Center (prostate, kidney and urinary

bladder), a Hematologic Neoplasia Center, and a Neurooncology Center.

e center has been certied as an Oncology Center since 2018. Since

then, other medical programs with forms of verication such as certi-

cates from other specialties have been included in the departments’ scope.

Discussion: Challenges: Lack of hierarchy between clinic sta (MQP)

and attending physicians, drastic culture change for the physicians and

hospital, self-governance of physicians, competition between specialists.

Solutions: Commitment through contracts, jointly developed patient

pathways, collegial involvement, joint committees and escalation via

management.

Conclusion: Advantages for physicians and patients outweigh disadvan-

tages. Certication/regulation helps greatly with standardization along

the patient pathway.

Disclosure Statement: e authors declare no conict of interest.

371

Symptom clusters of oncological patients in specialist

palliative home care – What are their needs?

Daniela Gesell1; Farina Hodiamont1; Julia Wikert1; Eva Lehmann-Emele1,2;

Claudia Bausewein1; Friedemann Nauck2; Maximiliane Jansky2

1Klinik und Poliklinik für Palliativmedizin, LMU Klinikum, München, Deutschland

2Klinik für Palliativmedizin, Universitätsmedizin Göttingen, Göttingen,

Deutschland

Background: Specialist palliative home care (SPHC) aims to improve and

preserve the quality of life of patients with life threatening diseases. Little

is known about the needs and co-occurring symptoms of oncological

patients in SPHC. We therefore aim to analyze the prevalence of physi-

cal symptom burden and psychosocial problems, and the occurrence of

symptom cluster of oncological patients in SPHC.

Methods: Prospective, cross-sectional, multi center study collecting data

reecting the complexity of patients’ situations in SPHC. Descriptive

statistics on physical and psychosocial burden assessed by Integrated

Palliative care Outcome Scale at the beginning of a care episode (time

between admission and discharge or death). Exploratory and conrma-

tory factor analyses to identify symptom and problem cluster.

Results: We included 778 patient episodes from 9 teams, with 566 (72.8%)

oncological diagnoses, average age 73 (SD±12) years, 49.8% female, mean

length of episode 19.8 (SD±20) days. Main physical burden was weak-

ness (522/565;92.4%), poor mobility (472/562;84%) and poor appetite

(378/566;66.8%), main psychosocial problems were family (414/563;73.5%)

and patient anxiety (346/561;61.7%). ree symptom clusters (psychosocial,

physical, and practical) were identied, with at least one cluster shown in

172/566 (30.4%) episodes. Patient episodes with practical cluster had lower

age and higher functional status compared to all episodes.

Discussion: To provide adequate care to people at the end of their life

and to address their needs, it is necessary to understand how their symp-

toms might interact, and plan accordingly. In the community setting, the

practical cluster is of particular importance for the teams and their coor-

dination of care.

Conclusion: Consideration of symptoms or problems related to each

other in dierent ways and the corresponding needs can support care

planning.

Funding: G-BA Innovation Fund, no. 01VSF18018.

Disclosure Statement: e authors declare the following: Co-Autorin Prof. Clau-

dia Bausewein, Präsidentin der deutschen Gesellscha für Palliativmedizin.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts160

384

Remdesivir is associated with lower mortality in cancer

patients hospitalized for COVID-19 across emerging variants

Essy Mozaari1; Aastha Chandak2; Chidinma Chima-Melton3;

Andre C. Kalil4; Stephanie H. Read5; Celine Der-Torossian1; Lauren Dau1;

Rikisha Gupta1; Mark Berry1; Robert L. Gottlieb6

1Gilead Sciences, Foster City, USA

2Certara, New York, USA

3UCLA Health, Torrance, USA

4University of Nebraska Medical Center, Omaha, USA

5Certara, London, United Kingdom

6Baylor Scott & White Health, Dallas, USA

Background: Cancer patients with SARS-CoV-2 infection are at high risk

of progressing to severe COVID-19 disease, hospitalization, and mortal-

ity. We examined inpatient all-cause mortality for cancer patients hospi-

talized with COVID-19 and treated with remdesivir (RDV) vs. not across

pre-Delta, Delta and Omicron variant of concern (VOC) periods.

Methods: We identied adults with a cancer diagnosis (ICD-10-CM:

C00.x- C96.x) hospitalized with a primary diagnosis of COVID-19 from

US PINC AI Healthcare Database. Patients treated with RDV within 2

days of admission vs. not treated with RDV during hospitalization were

matched using 1:1 preferential within-hospital propensity matching with

replacement. Patients were excluded if discharged within 3 days of RDV

initiation. Cox Proportional Hazards Model was used to examine 14- and

28-day mortality.

Result: 4,937 RDV-treated patients were matched to 2,088 unique non-

RDV patients (equivalent to 4,937 non-RDV based on matching with

replacement). In the PS-matched cohort, unadjusted mortality rate was

signicantly lower for RDV-treated patients at 14 and 28 days (16% vs

25%; p<.0001 and 23% vs 31.5%; p<.0001) as compared to patients not

receiving RDV.

Aer adjusting for baseline and clinical covariates, RDV had a signi-

cantly lower mortality risk compared to non-RDV across all VOC periods

for 14- and 28-day results [overall (41% and 33% lower risk, respectively),

pre-delta (35% and 25%), Delta (39% and 32%), Omicron (48% and 40%)].

Discussion: In the PS-matched cohort of cancer patients hospitalized

with COVID-19, lower mortality rates for the RDV cohort were consist-

ently observed across all VOC periods.

Conclusion: In the vulnerable cohort of cancer patients hospitalized with

a primary diagnosis of COVID-19, patients treated with RDV within

2 days of admission had signicantly better survival outcomes. RDV

demonstrated consistent benet across all emerging variant periods of the

pandemic before Omicron BA4/5.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

391

Patient guidelines based on evidence-based oncological

clinical practice guidelines

Sarah Lisa Messer1; Annika Oeser1; Ulrike Holtkamp2; Gregor Wenzel3;

Markus Follmann3; Nicole Skoetz1

1Evidence Based Medicine, Department I of Internal Medicine, Faculty of

Medicine and University Hospital Cologne, University of Cologne, Köln,

Deutschland

2German Leukemia & Lymphoma Patients‘ Association, Bonn, Deutschland

3German Guideline Program in Oncology, German Cancer Society, Berlin,

Deutschland

Background: e purpose of oncological patient guidelines is to provide

understandable information for informed decision-making in cancer

management. Evidence-based oncological practice guidelines oer rec-

ommendations, but they are oen dicult to comprehend for laypersons.

us, patient guidelines are created. We outline the development process

of patient guidelines funded by the German Cancer Aid, using DLBCL as

an example.

Methods: First, an evidence-based oncological practice guideline is cre-

ated. Topics are reviewed and prioritised in collaboration with patients

and patient representatives. Using a strict standardized methodology and

a template provided by the German Guideline Program in Oncology, a

patient guideline is created: Recommendations are reworded for simplic-

ity, avoiding technical terms. A feedback loop with experts and patients is

initiated, and following a public consultation phase, the nal version of a

patient guideline is published online and in print.

Result: e DLBCL patient guideline covers key practice guideline recom-

mendations in accessible language for patients and caregivers. It includes

various topics, especially therapy and follow-up care. e rst feedback

round is underway, and the consultation version is expected by February.

Discussion: Patient guidelines bridge complex oncological clinical prac-

tice guidelines and patient information needs, making information under-

standable and accessible. is accessibility empowers patients to actively

participate in their own care decisions.

Conclusion: e DLBCL patient guideline serves as an example for the process

of creating patient guidelines. All patient guidelines developed in the German

Guideline Program in Oncology, follow the same method. Ultimately, patient

guidelines play a crucial role in supporting patient-centred care by providing

clear and accessible information to aid informed decision-making.

Disclosure Statement: e authors declare no conict of interest.

419

Feasibility and learning outcomes of Lübecks

interprofessional training ward (LIPSTA): a mixed-methods

evaluation

Frederike Lüth1; Max Moll2; Birte Hildebrand1; Niklas Gebauer3;

Martina Traut4; Nikolas Christian Cornelius von Bubno3; Katrin Balzer1

1University of Lübeck, Institute for Social Medicine and Epidemiology, Nursing

Research Unit, Lübeck, Deutschland

2University of Lübeck, Student body of medicine and health care, Lübeck,

Deutschland

3University Hospital of Schleswig-Holstein, Campus Lübeck, Department of

Hematology and Oncology, Lübeck, Deutschland

4University Hospital of Schleswig-Holstein, Campus Lübeck, Central institution

for physiotherapy and physical therapy, Lübeck, Deutschland

Background: An important aim of health professionals’ education is to

promote competencies for interprofessional collaboration in clinical prac-

tice. erefore, the Lübeck interprofessional training ward (LIPSTA) was

implemented in the department of hematology and oncology in 2022.

During four-week joint assignments, students of nursing, human med-

icine and physiotherapy work together to care for several patients inde-

pendently under the supervision of professionals. Each LIPSTA rotation

has been evaluated to examine acceptance, feasibility and learning out-

comes of this placement model.

Methods: Mixed-methods evaluation with pre-post-design: Students’

(nursing n=7, medicine n=4, physiotherapy n=2) subjective interprofes-

sional competencies and satisfaction with the placement were surveyed at

several measurement points. Qualitative interviews were conducted with

students (n=10) and supervisors (n=7) aer each placement.

Result: Self-reported competencies in interprofessional collaboration

(Interprofessional Socialization and Valuing Scale, 1=very low, 7=very high)

increased from mean 5.2 (standard deviation (SD) 0.6) to 6.0 (SD 0.6) from

the beginning to the end of the placement. Qualitative data suggest distinct

improvements in interprofessional communication and teamwork. All

involved parties including patients welcomed this placement model while

professionals emphasized the eorts required for successful implementa-

tion. No adverse events attributable to the LIPSTA placement were noted.

Discussion: LIPSTA proved to be safe, feasible, and eective. However,

as the model is currently limited to one clinical department, only a few

students could benet from it.

Conclusion: e LIPSTA model holds high chances for the quality of edu-

cation and patient care and should become normalized routine in clinical

placements of health profession students.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 161

476

OncoBox-Compare – external data quality check for prostate

cancer centers and cancer registry

Katharina Weinert1; Philipp Kachel1; Sebastian Dieng2

1Krebsregister Rheinland-Pfalz im Institut für digitale Gesundheitsdaten, Mainz,

Deutschland

2OnkoZert, Neu-Ulm, Deutschland

Background: DKG-certied prostate centers record according to the

certication requirements and additionally report to their State Cancer

Registry in the format of the Oncological Basic Data Set (oBDS, www.

basisdatensatz.de). e pilot project initiated by OnkoZert (OZ) and the

Cancer Registry Rhineland-Palatinate (KR RLP) in cooperation with the

prostate cancer centers Trier and Ludwigshafen established a novel exter-

nal data quality check. e main objective was to understand the discrep-

ancy between data use for certication and reporting to KR RLP and to

gain insights on how to reduce documentation eorts in the long term.

e focus was on data quality.

Methods: e comparison between center and KR RLP data was based

on selected patient and tumor information using a common denition as

“center case” and was performed with the soware application “OncoBox-

Compare” (xml interface) implemented in the project, which allows anal-

yses on patient collective, case and eld level. e data format used was

the OncoBox prostate report (xml interface). e case group included

center patients with non-metastatic prostate cancer diagnosed in 2019,

discussed in the pre-therapeutic tumor conference, and treated at the

prostate center.

Result: For both centers, match at the patient collective level was greater

than 90%. is allowed verication of the centers’ case counting, eld-

level analyses and clarication of lost-to-follow-up cases using informa-

tion from the cancer registry data exchange.

Discussion: Match at the patient and tumor level is highly dependent on

match factors such as the indicator year or primary case count and is the

result of specic calculations.

Conclusion: Although the data elds dier between DKG certication

specications and oBDS, data reconciliation is possible. e joint anal-

ysis intensied the communication between center and cancer registry,

strengthened the trust and increased the data quality. e further approx-

imation of the data elds of the OncoBoxes to the oBDS makes sense and

was done for the new OncoBox Lung.

Disclosure Statement: e authors declare no conict of interest.

560

Speechlessness in Oncology: Inuence of Receiving

an Oncological Diagnosis -Results of a Prospective

Longitudinal Study

Thilo Dietz1; Vera Schiewer1; Johannes Bösche2; Eva Schneider2; Sarah-

Michêle Spielmann2; Anika Rütjes2; Frank Dracke2; Michael Kusch1

1Department of Internal Medicine, University Hospital Cologne, Köln,

Deutschland

2Oncology Nursing Department, Nursing Directorate, University Hospital

Cologne, Köln, Deutschland

Background: e Phenomenon of Speechlessness, measured by the

Kölner Fragebogen zur Sprachlosigkeit (KFS) [1] can be divided into an

intentional, a non-intentional and an emotional dimension. Extreme

emotional situations are considered central to emergence of speech-

lessness. Preliminary data suggest a signicant prevalence of emotional

speechlessness in oncology patients up to 5 years aer diagnosis [2]. ere

are no studies on whether an oncological diagnosis is a cause of speech-

lessness and whether it decreases during the course of the disease.

Methods: From June 2022 to August 2023, a prospective longitudi-

nal study was conducted including adult patients with an oncological

diagnosis within the last 120 days. Data was collected over three time

points (T1 to T3) with an interval of 60 days using the KFS [1].

Result: A total of N= 51 patients were enrolled (43% provided com-

plete information); the mean time from diagnosis to T1 was M = 43.24

(SD = 36.22) days. Results of a rmANOVA with Bonferroni correction

showed a significant increase in emotional speechlessness between T1

and T2 (6.7; F = 4.651; p = .027). Intentional and non-intentional

speechlessness remained unchanged between T1, T2 and T3. Results of

linear regression analysis indicated no significant influence of the time

between diagnosis and the expression of speechlessness at T3.

Discussion: e results indicate that receiving an oncological diagnosis

leads to an increase in emotional speechlessness, while intentional and

non-intentional speechlessness remain unchanged.

Conclusion: e results support the notion that a cancer diagnosis is a

highly emotional event that causes speechlessness.

Indication of source:

1 Dietz,T. et al. (2022). Cologne questionnaire on speechlessness: Development

and validation. Current psychology, 1–12.

2 Dietz,T. et al. (2022). Caught in Speechlessness: First insights in patients with

oncology diseases. In 35. Deutscher Krebskongress, Krebsmedizin: Schnittstellen

zwischen Innovation und Versorgung, 23–26. Februar 2022, Berlin.

Disclosure Statement: e authors declare no conict of interest.

582

Patient and caregiver perspectives in hepatobiliary cancer

Raphael Mohr1; Reiner Lehmann2; Helen Beckmann3

1Charité - Universitätsmedizin Berlin, Medizinische Klinik m. S. Hepatologie und

Gastroenterologie, Berlin, Deutschland

2DontBePatient Intelligence GmbH, Hamburg, Deutschland 3AstraZeneca

GmbH, Hamburg, Deutschland

Background: In cancer therapy, perspectives of patients and caregivers

are highly important and should be included in treatment decisions. For

hepatocellular carcinoma (HCC) and biliary tract cancer (BTC), these

data are largely missing. New approaches to collect these data reliably can

be helpful to improve care of hepatobiliary cancers. We here conducted a

social media survey to gain better insight into the needs and expectations

of HCC and BTC patients and their caregivers.

Methods: An online survey distributed via social media was conducted,

with a detailed questionnaire assessing the diagnostic and therapeutic

patient journey, including quality of life (QoL) parameters, and the psy-

chological burden for patients and caregivers.

Result: 340 people (80 patients and 260 caregivers) completed the sur-

vey. 61% of patients considered QoL and long-term survival as equally

important. 64% of patients wished that their relatives/caregivers would

be involved in treatment decisions, and 45% of caregivers wanted to be

involved to a greater extent in therapeutic decision making. With an

EQ-5D-5L index score of 0.718, QoL of patients was generally low. With a

mean BSFC-s score of 16, there was a high burden on caregivers. Although

73% of the survey participants use the internet frequently and intensively

to obtain disease-related information, 61% did not know that there are

cancer support programs where they can seek help and counseling.

Discussion: Our results highlight the importance of patient and caregiver

perspectives for implementing a modern, holistic, individualized and

patient-centered care in hepatobiliary cancer. Due to the heterogeneity of

the analyzed population and the small sample size, interpretation of data

should be performed with caution.

Conclusion: In this social media-based survey, comprehensive data on

patient and caregiver perspectives in HCC and BTC point to a medi-

cal need to improve QoL and reduce the burden to caregivers. ere is

a high demand for more patient/caregiver information, education, and

involvement.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts162

591

Image-guided options in malignant tumor growth of the

visceral medicine - representative case series

Udo Barth1; Frank Meyer2; Jazan Omari3; Zuhir Halloul1

1Division of Vascular Surgery; Dept. of General, Abdominal, Vascular and

Transplant Surgery; University Hospital, Magdeburg, Deutschland

2Dept. of General, Abdominal, Vascular and Transplant Surgery; University

Hospital, Magdeburg, Deutschland

3Dept. of Radiology and Nuclear Medicine, University Hospital, Magdeburg,

Deutschland

Background: Visceral diseases may appear complex, in particular, if they

have a vascular dimension.

Aim/Methods: Practice-relevant demonstration of an exemplary case

series w/ case-specic characteristics.

Result (cases):

1) Male pat. (72 yrs. old) w/ primary iliaco- & subsequently mesenterico-

enteral stula w/ recurrent bleedings due to inltrating Tu growth

(rectal Ca) leading subsequently to: i) right AIE stenting, ii) coiling

of right AIC/AII branches, iii) local Tu/stula excision + right AIE

ligation.

2) Male pat. (70 yrs. old) w/ AEG-Tu type II + esoph. inltration lead-

ing to gastrectomy, splenectomy & esoph. resection + colon-segment

interposition (histology: pT2aN1[1/18]L1V1G3) - SEMS for subse-

quent anastomotic insiuciency; later: “high-ow“-aortoesoph. stula

w/ hemorrhage into esoph. lumen.

3) Male pat. (79 yrs. old) w/ ureteroiliac stula & hematuria; catheteriza-

tion of actinic ureteral strictures due to neoadj. radiochemoTx (sub-

sequently, abdominoperineal rectum exstirpation (suprasphinctary

cancer, ypT3ypN0M0) w/ Amplatzer insertion into right AII & iliac

stenting from le AFS (“cross-over maneuver“).

4) Male pat. (78 yrs old) w/ right hemicolectomy due to Ca of ascending

colon (med. history; signicant for CMI w/ arteriosclerotic stenoses of

all 3 mesenteric arteries leading to PTA of all 3 mesenteric arteries &

stenting of AMS) & re-laparotomy for lavage.

5) Male pat. (82 yrs. old - severe risk factors) w/ metastasizing Ca of

the papilla of Vater - local bleeding w/ image-guided cessation of the

bleeding by means of prox. & dist. coiling of the bleeding site at periph.

branches of the sup. et inf. pancreaticoduod. arteries.

Conclusion: Measures comprise i) stenting/prelesional coiling for cessa-

tion of bleedings, ii) PTA/stenting in mesenteric arteriosclerosis (acute/

chronic mesenteric ischemia) for recanalization, iii) stenting in case of

aneurysm/dissection, iv) injection of substances in (pseudo-)aneurysm.

Disclosure Statement: e authors declare no conict of interest.

619

Mid-term nding after pancreatic trauma mimics pancreatic

tumor lesion

Kilian Dossow1; Frank Meyer1; Sara Acciu1; Christine March2;

Aristotelis Perrakis1; Roland Croner1; Sara Al-Madhi1

1Dept. of General, Abdominal, Vascular and Transplant Surgery; University

Hospital, Magdeburg, Deutschland

2Dept. of Radiology and Nuclear Medicine, University Hospital, Magdeburg,

Deutschland

Background: Pancreatic tumor lesion can be considered a demanding

dierential diagnosis.

Methods: Scientic case report.

Result: (CASE DESCRIPTION):

Medical Hx: - CURRENT: 57-years old male patient was presented with

tumor(-like) lesion of the pancreas of unclear dignity in CT scan per-

formed for staging purpose of a histologically diagnosed prostate cancer;

no complaints or “B-symptomatology” (status aer abdominal trauma &

posttraumatic conservatively treated pancreatitis in 2020 [1.5 years ago])

Secondary diagnoses: Prostate cancer (rst diagnosis, 06/2021) with open

prostatectomy

Clinical nding: Good clinical & normosome nutritional as well as car-

diopulmonarily compensated status; abdominal wall so, no muscular

defense, scar of a median laparotomy w/o inammatory signs

Diagnostic measures: - LAB: No elevated inammatory, cholestasis param-

eters & tumor markers (CA19-9: < 9 U/mL, CEA: 2.4 ng/mL) - GLDH

minimally elevated

–oracic/Abdominal CT scan (in a dierent hospital): Fluid formation

within the pancreatic corpus, no clear tumor lesion, no cholestasis

–EUS: Semiliquid area within the isthmus, the remaining pancreas with

no nding

Histopathology (of transgastric puncture probe): Pancreatic necrosis with

slight hint for malignancy.

Clinical course: Aer uncomplicated EUS-guided puncture, case was

repeatedly presented in tumor board conference incl. polytrauma-related

images with declining local nding.

Diagnosis: Fluid formation within the pancreatic corpus aer traumatic

pancreatic contusion and posttraumatic pancreatitis.

Dierential diagnosis: Pseudocyst, cystic (serous-cystic, mucinous-cystic)

pancreatic lesion.

erapy: Conservative approach

Proceeding: Control imaging using ultrasound aer 3 months incl. pros-

tate cancer.

Conclusion: Abdominal trauma is a not rarely occurring clinical event/

nding in the emergency room with a broad spectrum of clinical aspects,

which can be considered a challenge for the abdominal surgeon (as in the

presented case.

Disclosure Statement: e authors declare no conict of interest.

620

First Analysis of Quality of Life and Patient Satisfaction of

Molecular Oncology Patients in Germany– the Cross-sectional

Molecular Tumour Board Freiburg Analysis

Linda Gräßel1; Michael Kruszewski1; Julia Kühn1; Rebeka Javorniczky1;

Katharina Herzog2; Julius Wehrle1; Johannes Jung1,3,4; Henriette Bertemes1;

Martin Werner5,6; Justus Duyster1,5,7; Mtb-Fr Network5;

Cornelius Miething1,5; Melanie Börries5,7,8; Lena Illert1,3,4,5,7

1Department of Hematology, Oncology and Stem Cell Transplantation, Faculty

of Medicine, Freiburg University Medical Center, Freiburg, Deutschland

2Insitute for Human Genetics, University Medical Center Innsbruck, Innsbruck,

Österreich

3Clinic and Polyclinic for Hematology and Oncology, Faculty of Medicine,

Technical University of Munich, München, Deutschland

4Center for Personalized Medicine, Klinikum r.d. Isar, Technical University

Munich, München, Deutschland

5Comprehensive Cancer Center Freiburg, Faculty of Medicine, Freiburg

University Medical Center, Freiburg, Deutschland

6Department of Pathology, Faculty of Medicine, Freiburg University Medical

Center, Freiburg, Deutschland

7German Cancer Consortium (DKTK), Partner site Freiburg; and German Cancer

Research Center (DKFZ), Heidelberg, Deutschland

8Institute of Medical Bioinformatics and Systems Medicine, Freiburg University

Medical Center, Faculty of Medicine, University of Freiburg, Freiburg,

Deutschland

Background: e Molecular Tumor Board Freiburg (MTB-FR) aims to

identify and evaluate potential targets for personalized therapy in can-

cer patients with mostly advanced disease and limited to no conventional

therapeutic options. Aim of this study is to dene the subjective thera-

peutic benet by analyzing patient-reported outcome measures (PROMs)

such as quality of life (QoL) and patient satisfaction.

Methods: We conducted a paper-based survey in a cross-sectional design

to analyze PROMs of the participants of the Molecular Tumor Board

Freiburg registry trial. We adapted the pre-existing German version of

the Patient Satisfaction with Cancer-related Care (PSCC-G) for patients

undergoing molecular diagnostics and treatment recommendation in a

molecular tumor board (mPSCC-G). Health-related (HRQoL) and can-

cer-specic quality of life were assessed by using the validated and widely

used EQ-5D-5L and EORTC-QLQ-C30 respectively.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 163

Result: e patient characteristics of the 101/257 (=39.3%) evaluable

responses reected our entire cohort of MTB-FR registry study partic-

ipants. mPSCC-G analysis showed high overall satisfaction of MTB-FR

participants, with 76.2% stating that case discussion at MTB-FR was ben-

ecial to them. EQ-5D-5L and EORTC-QLQ-C30 analyses indicate that

HRQoL is higher in patients receiving therapy recommended by the MTB.

In addition, patients receiving personalized treatment tend to report lower

symptom burden and higher functional scores.

Discussion: In addition to OS/PFS, PROMs should be collected more

widely, placing patient-centered care at the heart of the treatment pro-

cess for patients with advanced cancer. To ensure that as many patients as

possible benet from this diagnostic tool, it is essential that patients are

enrolled in a MTB in a timely manner.

Conclusion: To the best of our knowledge, this is the rst structured anal-

ysis of patient satisfaction and QoL of participants in a molecular tumor

board registry trial in Germany demonstrating the subjective therapeutic

benet of patients.

Disclosure Statement: e authors declare no conict of interest.

629

Plato2: Nationwide Platform for linking and analysing

Oncology Research Data

Sylke Zeissig1; Monika Klinkhammer-Schalke1; Benjamin Barnes2;

Johannes Bruns3; Bianca Franke1; Tobias Hartz4; Anne Hennings1;

Hedy Kerek-Bodden5; Jan Krischan Krause3; Klaus Kraywinkel2;

Gerd Nettekoven6; Olaf Ortmann1,3; Thomas Seuerlein3;

Kerstin Weitmann4; Simone Wesselmann3; Stefan Rolf Benz1

1Arbeitsgemeinschaft Deutscher Tumorzentren e.V., Berlin, Deutschland

2Zentrum für Krebsregisterdaten am Robert-Koch-Institut, Berlin, Deutschland

3Deutsche Krebsgesellschaft e.V., Berlin, Deutschland

4Plattform § 65c, Magdeburg, Deutschland

5Haus der Krebs-Selbsthilfe – Bundesverband e.V., Bonn, Deutschland

6Deutsche Krebshilfe, Bonn, Deutschland

Background: For a nationwide, event-related compilation and evaluation

of oncological data, a platform is needed that is professionally supported

with experience in clinical-scientic evaluations. To answer specic ques-

tions, the cancer registry data should be linked with other relevant data

in order to gain new scientic knowledge. In addition, the platform will

provide an infrastructure for prospective registry based trials. e Act on

the Compilation of Cancer Registry Data (Gesetz zur Zusammenführung

von Krebsregisterdaten (KRDa-ZuG)) supports the establishment of this

platform.

Methods: We chose six use cases on topics and entities to form the basis of

our investigations. Interdisciplinary expert teams are currently analysing

the necessary steps and proposed solutions. For each use case the data

requirements will be identied and the suitability of the data set link-

age will be evaluated on the basis of the applicable regulations especially

under current federal/ state law.

Result: e project is currently in development phase. First step is to take

stock of the current situation. It will be examined which questions can

already be dealt with today available data, which projects would only be

feasible with a very high eort and which would not be feasible at present

and need data linkage with other data sources.

Discussion: e Phase 2 platform concept seeks to enable timely and

accessible nationwide inquiries and evaluations of specic research ques-

tions in clinical cancer medicine. e realm of research questions that can

be addressed using healthcare data will thus be continuously expanded.

Conclusion: e project’s results will facilitate retrospective and pro-

spective evaluations using study and routine data for healthcare research

and clinical therapies, further advancing the eld. By lever-aging the

Plato2 platform, we strive to enhance healthcare outcomes and informed

decision-making.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

634

Informationsbedürfnisse von Patient*innen mit

fortgeschrittenem Lungen-, Ösophagus- und Leberkarzinom -

Ergebnisse eines Realist Reviews im Projekt Onco:cide

Stephan Nadolny1,2; Lydia Ilin3; Christian Heise4; Johannes Porzelle5;

Julia Roick3; Matthias Richter3; Patrick Michl4; Henning Rosenau5;

Jan Schildmann1

1Institut für Geschichte und Ethik der Medizin, Prolzentrum

Gesundheitswissenschaften, Medizinische Fakultät, Martin-Luther-Universität

Halle-Wittenberg, Halle, Deutschland

2Institut für Bildungs- und Versorgungsforschung im Gesundheitsbereich,

Hochschule Bielefeld, Bielefeld, Deutschland

3Lehrstuhl für Soziale Determinanten der Gesundheit, Fakultät für Sport- und

Gesundheitswissenschaften, Technische Universität München, München,

Deutschland

4Klinik für Gastroenterologie, Infektionskrankheiten und Vergiftungen,

Universitätsklinikum Heidelberg, Heidelberg, Deutschland

5Interdisziplinäres Zentrum Medizin – Ethik – Recht, Juristische und

Wirtschaftswissenschaftliche Fakultät, Martin-Luther-Universität Halle-

Wittenberg, Halle, Deutschland

Background: e decision-making ability of people with cancer can be

compromised by several factors. A variety of interventions have been

developed to improve decision-making. Professionals perceive them as

conicting with existing practice, resource intensive and therefore the

degree of implementation is low.

e project aims to optimize the existing informed consent process with a

low-threshold, multimodal intervention. A realist review was conducted

to provide a theoretical basis. One research question focuses on the infor-

mation needs of patients throughout the disease trajectory.

Methods: We searched Medline, Cinahl, PsycInfo, Web of Science and

Scopus from 2005 to October 2022. We included studies focusing on

the information needs of patients with lung, esophageal and liver cancer

regardless of the study design or setting. Two researchers independently

screened and extracted the data. We analyzed the data with respect to the

dierent information needs at dierent stages of the disease process (diag-

nosis, treatment, post-treatment, end of life) as well as cancer progression.

Result: Database search yielded 1022 articles. Aer title and abstract

screening 111 remained and 60 studies were included in the analysis

aer screening full texts. Most studies (n=30) focused on the diagnosis

and treatment phase and only a minority on the end-of-life phase (n=5).

Important information needs are prognosis, treatment options, cancer

symptoms, side eects, coping and self-care. e need for information

on treatment options decreases over the disease trajectory with a greater

focus on coping and self-care in the post-treatment phase.

Discussion: Patients need varying information over the course of their

disease. Due to heterogeneous reporting, it was dicult to dierentiate

the information needs in relation to cancer progression or staging.

Conclusion: More emphasis should be placed on coping and self-care at

an early stage, e.g. to build resilience, as it can be challenging for cancer

patients to anticipate their needs when they are preoccupied with treat-

ment decisions.

Disclosure Statement: e authors declare no conict of interest.

635

Surveillance and eld service improve quality and quantity in

the Rhineland-Palatinate Cancer Registry

Petra Plachky; Katharina Weinert; Philipp Kachel

Cancer Registry of Rhineland-Palatinate in the Institute for Digital Health Data

RLP gGmbH, Mainz, Deutschland

Background: Clinical-epidemiological cancer registration serves as

key driver in monitoring and improvement of oncological treatment in

Germany. In this context close interaction between cancer registries and

physicians is mandatory. One parameter is to supply main information on

a cancer patient with minimal eort for the inquiring physician. For this

aim the cancer registry in Rhineland-Palatinate developed the oncological

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts164

patient record (onkologische Patientenakte, oPA) a unique service which

comprises a chronological merge of main information on each tumor

diagnosis, treatment and follow-up. is includes reports from physicians

from other federal states. e oPA can easily be retrieved via personal

Methods: Cancer registration in Germany follows the recommendations

of the unique oncological basis dataset. In accordance to these specica-

tions the database of the cancer registry in Rhineland-Palatinate provides

epidemiological and clinical data from 1997 and 2016 on, respectively.

us, this database consists of several million data points. is huge

amount of data is structured and included as a summary of the best infor-

mation in the oPA. e number of meanwhile available records was cal-

culated by R.

Result: As of yet the cancer registry of Rhineland-Palatinate provides an

oPA for more than 200.000 tumors, this represents about 65 % of clinically

reported tumors.

Discussion: One obligation of cancer registration in Germany is the sup-

port of physicians with comprehensive information on cancer patients.

Since cancer diagnosis and treatment occurs multidisciplinary and

involves specialists in dierent institutions it is necessary to centralize all

information in a structured way on one platform. Accordingly, the oPA

was established in Rhineland-Palatinate.

Conclusion: e oPA provides a unique service for physicians to obtain

crucial information on cancer patient on a condensed level and with easy

access.

Disclosure Statement: e authors declare no conict of interest.

646

PromotingPhysicians‘ Communicative Competence and

Performance(KPAP Study, funded by DKH) - Results on

Self-Ecacy and Burnout Symptoms

Isabel Hamm1; Frank Vitinius1; Bernd Sonntag1; Wolfgang Söllner2;

Stephanie Stock3; Wolf Langewitz4; Alexander Wünsch5; Martin Hellmich6;

Hannah Fischer1; Nadine Haupt1; Barbara Stein7

1Klinik und Poliklinik für Psychosomatik und Psychotherapie,

Universitätsklinikum Köln, Köln, Deutschland

2Paracelsus Medizinische Privatuniversität, Nürnberg, Deutschland

3Institut für Gesundheitsökonomie und Klinische Epidemiologie,

Universitätsklinikum Köln, Köln, Deutschland

4Psychosomatische Medizin, Universitätsspital Basel, Basel, Schweiz

5Inselspital, Universitätsspital Bern, Universitätsklinik für Medizinische

Onkologie, Bern, Schweiz

6Institut für Medizinische Statistik und Bioinformatik, Universität zu Köln, Köln,

Deutschland

7Klinik für Psychosomatische Medizin und Psychotherapie, Klinikum Nürnberg,

Nürnberg, Deutschland

Background: Eective communication between oncology physicians and

patients is critical to quality cancer care. Ineective communication can

lead to psychological distress, professional dissatisfaction, and burnout

symptoms in physicians. e project KPAP (Promoting Communicative

Competence and Performance of Physicians and Patients), funded by

German Cancer Aid, aims to evaluate long-term eects of a communica-

tion training program for oncology physicians. Results on self-perceived

self-ecacy and burnout symptoms will be reported.

Methods: e communication training consists of 2.5 days interactive

training with a refresher session (at least three months aer the basic

training). It includes role-playing with actor patients, based on chal-

lenging conversational situations of the participants. Self-assessments of

self-ecacy and burnout symptoms were collected at the beginning (t0)

and end (t1) of basic training, during the refresher session (t2), and at least

3 years aer attending the basic training (t3). Self-ecacy is assessed with

an adapted questionnaire from Falloweld, Lipkin, and Hall and burnout

symptoms with the Maslach Burnout Inventory. Repeated measures anal-

yses of variance and mediation analyses will be conducted.

Result: From 2015 to 2019, 20 communication trainings were conducted

with 209 physicians in Cologne. Long-term follow-up surveys have been

conducted since 2019. Recruitment and implementation of t3 were com-

plicated by the occupational mobility of participants and the Covid-19

pandemic. Long-term data from t0 and t3 for self-ecacy and burnout are

available for 89 participants and will be reported at the conference

Discussion: e study is providing valuable insights into the long-term

eects of this training. Results on self-ecacy and burnout will be an

essential part of the assessment of its eectiveness.

Conclusion: e long-term data will be used to make recommendations

for the design and frequency of future trainings.

Disclosure Statement: e authors declare no conict of interest.

664

The Center for Integrated Oncology (CIO) Cologne Summer

Academy- an innovative oncology teaching program for high

school students

Viktoria Kohlhas1; Ida Dareskog2; Jürgen Wolf3; Cornelia von Levetzow4

1CIO Cologne/Department I of Internal Medicine/University Hospital of

Cologne/Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf

(CIO ABCD), Cologne, Deutschland

2CIO Cologne, University Hospital Cologne, Center for Integrated Oncology

Aachen Bonn Cologne Duesseldorf (CIO ABCD), Cologne, Deutschland

3Department I of Internal Medicine/CIO Cologne/University Hospital of

Cologne/Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf

(CIO ABCD), Cologne, Deutschland

4CIO Cologne, University Hospital Cologne, Center for Integrated Oncology

Aachen Bonn Cologne Duesseldorf (CIO ABCD), Cologne, Deutschland

Background: As a CCC, e CIO wants to provide an excellent teaching

infrastructure for oncology training. Inspired by the Summer Academies

of US-American cancer centers, we launched the rst CIO Summer

Academy in 2014 with 5 students and have expanded the program in

subsequent years to up to 12 students. Our goal was to give talented and

motivated high school students the opportunity to get a deep insight into

translational cancer research in order to encourage them to pursue careers

in the eld of cancer research.

Methods: Students experienced four weeks of research-focused didactic

and experiential learning in dierent laboratories and a clinical trial oce.

ere, the scholars worked individually on their own research projects

and attended a series of cancer biology lectures presented by young sci-

entists of the CIO, also improving the lecturers’ teaching skills. At the end

of the program, scholars presented their projects orally, as well as during

a poster session.

Result: During the 9 years, 66 students have participated in this program

and learned important skills to help prepare them for success in their

future careers in science and medicine. e annual evaluation helped to

improve the program contents. On feedback surveys, the students were

highly enthusiastic about this opportunity of having such a deep and

application-oriented insight into translational cancer research.

Discussion: We believe that this program represents a model for inspir-

ing students to focus on translational cancer research. Accordingly, 12

of the former participants already worked as student helpers in research

groups of our CCC. Participants from the rst years are now working on

their doctoral theses and have completed research stays at international

institutions.

Conclusion: We are convinced that such a program is extremely useful

to give students the opportunity to get an insight that is otherwise only

possible at the end of their studies at the earliest. is has been successful

in conveying enthusiasm for the complex interrelationships in oncology

and in attracting participants to this subject.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 165

693

Analysis of the implementation of the Uniform Oncology

DataSet in physicians’ letters at CIO Cologne

Vanessa Schulz1; Scarlett Berressem1; Wolfgang Schröder2;

Axel Heidenreich3; Thomas Zander4; Jürgen Wolf4

1CIO Cologne, University Hospital Cologne, Center for Integrated Oncology

Aachen Bonn Cologne Duesseldorf (CIO ABCD), Cologne, Deutschland

2Department of General, Visceral Surgery, and Surgical Oncology, University of

Cologne, Cologne, Deutschland

3Department of Urology, Uro-Oncology, Robot-Assisted and Specialized

Urologic Surgery, Faculty of Medicine and University Hospital Cologne,

University of Cologne, Cologne, Deutschland

4Department I of Internal Medicine, University of Cologne, Center for Integrated

Oncology Aachen Bonn Köln Duesseldorf (ABCD), Cologne, Deutschland

Background: Physicians in NRW are legally obligated to report oncolog-

ical cases to the state cancer registry and are supported in this by trained

data managers. Physician letters (PL) are a central source but do not have

to contain all obligatory contents of the Uniform Oncology Data Set

(UODS). Nevertheless, completeness is a helpful chance to reduct per-

sonell costs for tumordocumentation. is work analyzes the status of

reportable information in already very high-quality PL, to identify possi-

ble center-specic potential for improvement.

Methods: A randomly selected ten percent sample of PL from the CIO was

analyzed with regard to documentation completeness using prospectively

dened main and subcategories of the contents of the mandatory UODS.

262 PL of newly diagnosed patients of the year 2021 were examined.

Result: Highest rates for overall completeness were found in the

Esophageal cancer center. e average of all centers was about 50%.

With regard to the main categories “residual status” and “conrmation

of diagnosis”, almost all certied centers were able to achieve between 80

and 100%. e Prostate center achieved a 100% documentation rate in

the before mentioned main categories. Decits were oen found in the

main categories “surgeon (name)”, “tumor conference”, “therapy recom-

mendation”, and “additional contacts”.

Discussion: Ratios of 50% can be considered positive since many UODS

contents do not necessarily have to be found in the PL. Yet there seems to

be room for improvement in selected clinics, especially in the adoption of

therapy recommendations in the PL. e same applies to additional con-

tacts such as information about psycho-oncological support.

Conclusion: e investigations show a high number of UODS-relevant

contents in the CIO PL. Nevertheless, potential for improvement was

identied. Simple modications in the form of structured text modules or

automatic transfers of certain clinical information could help by oering

physicians an ecient way to improve decits.

Disclosure Statement: e authors declare no conict of interest.

714

Support of Certied Centers – Comprehensive Service of the

Cancer Registry of Rhineland-Palatinate

Christina Justenhoven1; Jan Helge Folkerts1; Heinz Kirchen2;

Alexander Desuki3

1Cancer Registry of Rhineland-Palatinate in the Institute for Digital Health Data

RLP gGmbH, Mainz, Deutschland

2Hospital Barmherzige Brüder Trier, Trier, Deutschland

3University Cancer Center Mainz (UCT Mainz), University Medical Center of the

Johannes Gutenberg-University Mainz, Mainz, Deutschland

Background: Cancer registries have been established in each federal state

in Germany. One statutory obligation of cancer registries is the support of

cancer centers. Accordingly, the cancer registry of Rhineland-Palatinate

compiled a catalogue of services which are provided to oncological

centers. ese services aim to support certication processes as well as

accomplishment of individual requests.

Methods: Number of provided services, such as datasets, reports, analyses

and presentations were calculated and correlated to the number of certi-

ed centers in Rhineland-Palatinate in the time-period 2018-2023.

Result: e number of certied centers increased from 47 to 69 in the

years 2018 to 2023 in Rhineland-Palatinate. During this time period more

than 280 datasets were transferred to oncological centers. In addition to

more than 150 automatically generated reports per year centers are sup-

ported by individual analyses. Yearly invitation to quality conferences is

standard as well as support of dierent events organized by the centers

(e.g. audits) with presentations by members of the cancer registry.

Discussion: Publication of the results of the WiZen study initiated

a debate about quality of treatment in centers certied by the German

Cancer Society. In this light the supportive role of cancer registries regard-

ing the certication process has gained new interest. e cancer registry

of Rhineland Platinate established several services for oncological centers

during past years, which meanwhile enjoy great popularity.

Conclusion: It is mandatory that oncological centers are aware of the sup-

port cancer registries provide to medical institutions in particular during

certication processes.

Disclosure Statement: e authors declare no conict of interest.

723

Spermatogonial stem cell number in boys undergoing

testicular tissue cryopreservation for fertility preservation

Vesna Bojovic1; Claudia Krallmann1; Rod Mitchell2; Sabine Kliesch1;

Stefan Schlatt1; Nina Neuhaus1

1Centre of Reproductive Medicine and Andrology, University Hospital of

Münster, Münster, Deutschland

2MRC Centre for Reproductive Health, University of Edinburgh Division of

Reproductive and Developmental Sciences, Edinburgh, United Kingdom

Background: Cryopreservation of immature human testicular tissues

(ITT) is oered by the German fertility preservation (FP) network

Androprotect to boys at risk of germ cell loss. It is unknown if sper-

matogonia, which constitute the most advanced germ cell type within

these tissues, are present in normal numbers and if patients show recov-

ery of spermatogenesis following treatment. is study therefore aimed to

determine spermatogonial numbers and to assess the reproductive health

outcome aer gonadotoxic treatment.

Methods: ITT from 160 Androprotect patients were evaluated following

immunohistochemical staining for MAGEA4. Spermatogonia per round

tubular cross section (S/T) were analyzed in ≥ 25 tubules/patient and

Z-scores were calculated. Boys ≥ 16 yrs underwent semen analysis and

treatment protocols were obtained, for calculation of Cyclophosphamide

Equivalent Dose (CED) values.

Result: Most patients (99/154) had S/T Z-scores within the normal range,

including patients with Hodgkin’s lymphoma (HL). In contrast, sper-

matogonial numbers were severely depleted in 23 patients, including

patients with leukemia. Semen analyses in the follow-up cohort (n=24)

revealed recovery of spermatogenesis in 10/24 patients, with the majority

(6/10) belonging to the HL group. Calculated CED values revealed that

majority of patients who received low- and medium-risk gonadotoxic

treatment (<4000; 4000-8000 mg/m2, predominantly HL patients) showed

recovery of spermatogenesis. No sperm were found in leukemia patients

who received medium to high-risk (>8000 mg/m2) treatments.

Discussion: Spermatogonial number in the normal range indicates that

ITT can be used in the future for fertility restoration approaches. is

is of relevance, as recent studies revealed dierences in the recovery of

spermatogenesis, depending on the gonadotoxicity of treatments used as

inclusion criteria for participating in FP programs.

Conclusion: Cryopreservation of ITT should be oered to boys at signif-

icant risk of germ cell loss to preserve their chance to become biological

fathers in the future.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts166

768

Processual Multidimensional Psychosocial Diagnostics

according to LINA: Development of psychosocial diagnostics

for young adults with cancer (AYA) in the LINA model project

at the Robert-Bosch-Hospital (RBH) Stuttgart, Germany

Jens Stäudle1; Thomas Stork1; Karin Strube2; Christel Idler1;

Martin Kaufmann1; Walter Erich Aulitzky1; Hans-Georg Kopp1

1Robert-Bosch-Krankenhaus, Hämatologie, Onkologie und Palliativmedizin,

Stuttgart, Deutschland

2Strube Stiftung, Stuttgart, Deutschland

Background: e LINA project at Robert-Bosch-Hospital in Stuttgart

addresses the multifaceted psychosocial challenges faced by young adults

diagnosed with cancer. is study aims to introduce the innovative pro-

cess-oriented multidimensional psychosocial diagnostic approach devel-

oped within the LINA project.

Methods: e LINA project focuses on addressing individual needs

of young cancer patients through a holistic framework encompassing

life-context orientation, integrated collaboration, empathetic engagement,

and proactive outreach. e core of this framework lies in the process-

oriented multidimensional psychosocial diagnostics, which involves con-

tinuous assessment of patients’ unique needs, resources, and challenges.

Unlike traditional static methods, this approach is dynamic, accompany-

ing patients throughout their illness journey.

Result: e diagnostic framework considers various dimensions inu-

encing patients’ well-being, including medical, legal, psychological, social,

and spiritual aspects. e collaboration between medical and psychoso-

cial teams ensures comprehensive and tailored patient care.

Discussion: e approach provides comprehensive and personalized sup-

port for young cancer patients. By integrating diverse diagnostic aspects,

it optimizes the alignment of support services with each patient’s distinc-

tive challenges. e continuous and dynamic nature of the diagnostics

enables adaptability to evolving patient needs.

Conclusion: e process-oriented multidimensional psychosocial diag-

nostics developed within the LINA project oer an innovative solution to

support young adults with cancer. However, further research is essential

to comprehensively evaluate the utility and eectiveness of this method-

ology. e LINA project constitutes a signicant step toward enhancing

psychosocial care for young cancer patients while highlighting the need

for ongoing assessment and renement.

Disclosure Statement: e authors declare no conict of interest.

787

Patients’ understanding of the “right not to know” in the

context of genetic testing

Paula Thomas1; Katharina Klein1,2; Ste Stegen3; Christoph Kowalski2;

Sven Asmussen4; Ute Felbor5; Dorothee Speiser6; Markus Feufel7;

Friederike Kendel1

1Charité-Universitätsmedizin Berlin, Geschlechterforschung in der Medizin

(GiM), Berlin, Deutschland

2Deutsche Krebsgesellschaft e. V., Berlin, Deutschland

3BRCA-Netzwerk e.V., Bonn, Deutschland

4Humboldt-Universität zu Berlin, Lehrstuhl für Bürgerliches Recht,

Wirtschaftsrecht und Ökonomik, Berlin, Deutschland

5Universitätsmedizin Greifswald, Institut für Humangenetik, Zentrum Familiärer

Brust- und Eierstockkrebs, Greifswald, Deutschland

6Charité-Universitätsmedizin Berlin, Zentrum Familiärer Brust- und

Eierstockkrebs, Klinik für Gynäkologie mit Brustzentrum, Berlin, Deutschland

7Technische Universität Berlin, Institut für Psychologie und Arbeitswissenschaft,

Berlin, Deutschland

Background: Learning about genetic risks allows taking action and using

prevention services whilst rejecting genetic information may serve a pro-

tective function for psychological stress and worries related to illness (1).

us, the “right not to know” has an important meaning from an ethical

and legal viewpoint. However, the signicance of the “right not to know”

for patients has not been explored in-depth.

Methods: As part of the G-BA funded project, dVP_FAM (01NVF20002), a

cross-sectional online survey was carried out with 224 participants who were

recruited via BRCA-Netzwerk e.V. e questionnaire included newly designed

and validated measuring instruments and two open-format questions. We

explored the subjective understanding of the “right not to know”. In addition, we

captured practical barriers or diculties, e.g. with insurances or in the workplace,

in relation to genetic counseling and/or testing. We summarized and structured

the responses according to Mayring (2015) and using MAXQDA soware.

Results: 81.7% of participants were female with a mean age of 48.4.

Regarding the “right not to know”, 68.8 % (n = 202) felt able to give a

personal denition. Signicant categories amongst others were “self-

determined decision” and “freedom”. Moreover, participants reported job-

and family-related worries, complications with various types of insurance

and uncertainty about declaring a pathogenic variant. Nonetheless, 97.1 %

(n = 171) would choose to undergo genetic testing again.

Discussion: e results suggest that clinicians and policy makers alike

should consider patient’s informational needs in relation to genetic test-

ing. Uncertainty surrounding insurance contracts should be addressed.

Conclusion: e “right not to know” seems to be a construct which holds

dierent conceptions from patients’ point of view and goes far beyond

simply rejecting genetic information.

1 Deutscher Ethikrat (2013, 30 April). Die Zukun der genetischen Diagnostik –

von der Forschung in die klinische Anwendung [Stellungnahme].

Disclosure Statement: e authors declare no conict of interest.

797

Postural control in patience with chemotherapy induced

polyneuropathy (CIPN)

Henrike Fischer1; Bastian Helm2; Ulf Seifart3; Fake Faker4

1Hochschule Fresenius Hamburg - Fachbereich Gesundheit & Soziales,

Hamburg, Deutschland

2AGAPLESION EV. KRANKENHAUS MITTELHESSEN, Gießen, Deutschland

3Klinik Sonnenblick, Marburg, Deutschland

4Philipps-Universität Marburg, Marburg, Deutschland

Background: Mamma carcinoma is the most common cancer in women;

every 8th woman will fall ill with. Due to high relative survival rate of 82%

long-term therapy side eects become more relevant; like chemotherapy

induced polyneuropathy (CIPN). In 30% of cases Paclitaxel leads to CIPN.

In combination with platinum analogs 70%.

Polyneuropathy leads to sensory disorders which may cause failure in

postural control till problems in standing balance in dependence of sever-

ity of CIPN. Present pilot study is served to prove impact of CIPN on

postural sway in dierent standing positions.

Methods: 83 breast cancer patients (CIPN N=20; chemotherapy + no

PNP (CTx) N=32; no chemotherapy (CG) N=31) passed posturography

in 6 standing positions with dierent base of support and sensory condi-

tions for 30 sec each, 2nd trail, barefooted on a force plate to rate postural

control in terms of Center of Pressure. 95% ellipse area (area), average

displacement medio-lateral and anterior-posterior were analyzed.

Result: CoP diers in area in tandem stance with closed eyes (p≤0.05)

between CIPN (37.1cm2) and CG (19.2cm2). All groups dier in numbers of

breakup in this standing condition (p≤0.001; 80% in CIPN, 38% in CTx, 61%

in CG). Proportion of patients who pass tandem stance with closed eyes at 2nd

trail diers between groups (p≤0.001; 25% in CIPN, 10% in CTx, 58% in CG).

Discussion: Impairment of postural control through CIPN is visible

in postural sway just in one standing condition under raised sensory

demands. It is noticed that this standing condition also shows higher rates

of breakup and achievement at 2nd trail.

Conclusion: Bi- and monopedal stances without sensory deprivations are

not enough to evaluate impairment of postural control in patients with

CIPN or to rate degree of CIPN. Outcomes are overlayed by eects of age

and practice. Further studies controlling these inuences could be used

to rethink methods to grade and predict symptoms of CIPN, which is

important not only for quality of life, but also rating of insurances.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 167

803

RNA-seq of a cohort of cancer patients demonstrates its

capacity to reclassify uncertain variants by unveiling aberrant

splicing events

Oliver Klaas1; Thomas Keßler1; Jonas Ingermann1; Florentine Scharf1;

Caroline Heintz1; Martin Wendlandt1; Evgenia Vibe1; Taisya Volodina1;

Sabrina Angerbauer1; Tobias Wohlfrom1; Verena Steinke-Lange1,2;

Andreas Laner1; Ariane Hallermayr1,2; Morghan Lucas1;

Julia Romic-Pickl1,2; ElkeHolinski-Feder1,2

1MGZ – Medizinisch Genetisches Zentrum, München, Deutschland

2Medizinische Klinik und Poliklinik IV, Campus Innenstadt, Klinikum der

Universität München, München, Deutschland

Background: Around 5-10% of cancers are caused by hereditary tumor

syndromes. For the current state-of-the-art method of gene panel testing

via whole-exome sequencing (WES), the diagnostic yield ranges between

15-25% for these syndromes. Additional high-throughput methods are

therefore required to increase the diagnostic yield. RNA-seq can guide

the reclassication of variants of unclear signicance (VUS) and detect

previously unknown causative variants by revealing aberrant splicing at

the RNA level.

Methods: We developed a cost-ecient, high-throughput RNA-seq

approach to analyze aberrant splicing events.

Result: A total of >100 cases have so far been investigated by RNA-seq, all

of which had been previously analyzed by NGS exome sequencing with-

out revealing a clear pathogenic variant. 97 cases carried a VUS, while 4

showed no initial variants of concern. RNA-seq helped to reclassify 7 VUS

to (likely) pathogenic variants. Of these, 5 variants aected an intronic

splice site, and 2 were missense variants outside of obvious splice-relevant

regions. For one case with no initially reported variants, RNA-seq identi-

ed the use of a cryptic exon in the APC gene, guiding further analysis of

the aected intronic region.

Discussion: RNA-seq can provide clinically relevant information on VUS

and help to establish a clear diagnosis for otherwise unsolved cases, e.g.

through detection of aberrant splicing. Cases with no initial variant may

also be elucidated by targeted analysis of high-relevance genes. Overall,

we were able to reclassify ~7% of cases that could not be molecularly

solved through DNA exome sequencing. us, the diagnostic yield is sig-

nicantly improved by RNA-seq, and patient care can be optimized based

upon a conrmed diagnosis of a hereditary cancer syndrome.

Conclusion: RNA-seq is a valuable tool for reclassifying VUS and uncov-

ering pathogenic aberrations by unveiling aberrant splicing events in

patients with hereditary tumor syndromes where no DNA variant was

initially detected.

Disclosure Statement: e authors declare no conict of interest.

836

Analysis of allelic loss and aberrant splicing in capture

RNA-seq data as a supplement to DNA germline testing to

increase diagnostic yield

Florentine Scharf1; Caroline Heintz1; Thomas Keßler1; Jonas Ingermann1;

Oliver Klaas1; Martin Wendlandt1; Evgenia Vibe1; Taisya Volodina1;

Sabrina Angerbauer1; Tobias Wohlfrom1; Verena Steinke-Lange1,2;

Andreas Laner1; Ariane Hallermayr1,2; Morghan Lucas1;

Julia Romic-Pickl1,2; ElkeHolinski-Feder1,2

1MGZ - Medizinisch Genetisches Zentrum, Munich, Deutschland

2Medizinische Klinik und Poliklinik IV, Campus Innenstadt, Klinikum der

Universität München, Munich, Deutschland

Background: Hereditary tumor syndromes account for 5-10% of can-

cers. Accurate identication of causal genetic variants in aected patients is

highly important for in-patient management. e diagnostic yield of whole-

exome sequencing (WES), which is the gold standard molecular diagnostics

approach, is between 15-25% for these syndromes. To further upli diagnos-

tic rates, high-throughput functional studies, like RNA-seq, are highly desired.

ey not only help in reclassifying variants of uncertain signicance (VUS)

but also uncover pathomechanisms, such as aberrant splicing or monoallelic

expres-sion, especially in cases where no variants were initially detected.

Methods: We developed a cost-ecient high-throughput RNA-seq

approach for the analysis of RNA phenotypes where we complement

polyA mRNA capture with enrichment of 49 cancer-associated genes

from PAXgene-derived RNA samples.

Result: We achieved ultra-high coverage sequencing data of ~3,500X

mean target coverage and, on average, 80% of exons covered with >50

read depth. Based on 13 positive and 34 negative controls for allelic loss,

we could show a statistically signicant dierence based on the allele fre-

quencies of heterozygous coding variants. In almost 80% of 24 positive

controls for aberrant splicing, we detected a dierence of >20% in the PSI

(percent-spliced in) score compared to 23 negative controls.

Discussion: Our workow provides high quality RNA-Seq data, which

allows the assessment of splicing events and allelic imbalance. Our data

on the comparisons between positive and negative controls substantiate

the possibility of an automated high throughput pipeline.

Conclusion: is work represents the basis for the implementation of tar-

geted RNA-Seq in cancer diagnostics, in which we want to establish the paral-

lel analysis of Whole Exome and RNA sequencing to increase the diagnostic

yield and turnaround time for patients with hereditary tumor syndromes.

Disclosure Statement: e authors declare no conict of interest.

912

A collaboration idea between HBOC-CC and accredited breast

and gynecologic tumor centers in Berlin and Brandenburg:

quality and satisfaction

Sabrina Glagau1; Nanette Kalmbach1; Grazyna Krueger2; Nicole Zilski1;

Jens-Uwe Blohmer1; Dorothee Speiser1; Nikola Bangemann3

1FBREK-Zentrum der Charité, Klinik für Gynäkologie mit Brustzentrum Charité-

Universitätsmedizin Berlin, Berlin, Deutschland

2Klinik für Gynäkologie mit Brustzentrum Charité-Universitätsmedizin Berlin,

Berlin, Deutschland

3Brustzentrum und systemische Gynäkoonkologie, Carl-Thiem-Klinikum,

Cottbus, Deutschland

Background: e Hereditary Breast and Ovarian Cancer Center Charité

(HBOC-CC) has a unique patient population, which this study attempts

to describe, as well as potential hazards of the cooperation model.

Methods: A collaboration idea between HBOC-CC and accredited breast

and gynecologic tumor centers in Berlin and Brandenburg for patients

with breast and/or ovarian cancer has been formed since 2017. Data from

patients who underwent genetic testing at HBOC-CC between 2017 and

2021 aer being advised about it by specialized cooperating clinicians at

their primary hospital were examined. In addition, we created a comput-

erized survey that the medical professionals at the participating accredited

cancer centers may use to rate our collaboration.

Result: Between 2017 and 2021 916 patients had genetic panel analyses;

218 (23,8%) patients showed a pathogenetic variant in one of the estab-

lished core genes; among them 134 (14,6%) in BRCA1/2. 59 (27,1%)

patients had been diagnosed with TNBC, of which 44 (20,2%) had path-

ogenic germline variants in BRCA1/2. 34 Ovarian cancer patients had

pathogenic germline variants (15,6%); 8 (3,7%) patients of these were

diagnosed with breast and ovarian cancer simultaneously. A total of 16

(69,6%) of the participating physicians took part in the survey. Each

partner in a collaboration nds that it reduces their workload in organi-

zational, technical, and professional areas. Most participants see opportu-

nities for improvement in the eld of documentation.

Discussion: is cooperation model seems to help clinicians as well as

patients. Detection rates were similar to those in other settings, Survey

results showed that documentation eort should be addressed.

Conclusion: Digitalization of the cooperation model could further

increase detection rates of pathogenic germline variants using digitized

screening in the future. Furthermore, documentation could be reduced

using edocs.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts168

918

Immunocompromised patients hospitalized with COVID-19

in the US: patient characteristics and clinical outcomes across

emerging variants

Essy Mozaari1; Aastha Chandak2; Andre C. Kalil3;

Chidinma Chima-Melton4; Mel Chiang5; Eunyoung Lee1; Rikisha Gupta1;

Chen-Yu Wang5; Robert L. Gottlieb6

1Gilead Sciences, Foster City, USA

2Certara, New York, USA

3University of Nebraska Medical Center, Omaha, USA

4UCLA Health, Torrance, USA

5Gilead Sciences, Taipei, Taiwan

6Baylor Scott & White Health, Dallas, USA

Background: e COVID-19 pandemic continues to evolve with emerg-

ing variants and changing clinical practice guidelines. We describe

patient characteristics, severity, and mortality across pre-Delta, Delta and

Omicron variant of concern (VOC) periods.

Method: Using the PINC AI Healthcare Database, immunocompromised

adults (including cancer, solid organ and hematopoietic stem cell trans-

plant, hematologic malignancies, asplenia, bone marrow failure/aplastic

anemia) hospitalized with a primary diagnosis of COVID-19 were iden-

tied. We examined patient characteristics, COVID-19 disease severity

upon admission and mortality outcomes over time and by severity upon

admission.

Result: 73,013 immunocompromised adults were hospitalized with a

primary diagnosis of COVID-19. Compared to pre-Delta, immunocom-

promised patients in the Delta period required higher oxygenation levels

upon admission (20.4% vs. 16.8% high-ow oxygen/non-invasive ventila-

tion (HFO/NIV); 3.2% vs. 2.8% invasive mechanical ventilation (IMV)/

ECMO; p<0.0001) and had higher mortality rates (19.6% vs. 18.2%;

p<0.0001).

Compared to Delta, patients in the Omicron period required lower oxy-

genation levels upon admission (14.1% vs. 15.5% HFO/NIV; 25.8% vs.

30.8% low-ow oxygen (LFO); p<0.0001) and had lower mortality rates

(17.8% vs. 19.6%; p<0.0001).

Mortality rates were highest for patients aged 65+ years or requiring IMV/

ECMO upon admission, followed by HFO/NIV, those in ICU or LFO

upon admission.

Discussion: Characteristics of immunocompromised COVID-19 patients

varied considerably across VOC periods with mortality remaining high.

Conclusion: is study provides a temporal view of COVID-19 hospi-

talizations and outcomes, in the context of emerging variants, providing

critical information for clinical practice decision making for a vulnerable

cohort of immunocompromised patients.

Reference:

Mozaari E. et al. Clin. Infect. Dis. (2023): ciad460.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.:

940

Cancer and psyche - spectrum extending from inconspicuous

to syndromal adjustment disorders

Michael Brinkers1; J. Drewes1; Giselher Pfau1; Frank Meyer2

1Outpatient Clinic for Pain Therapy, Dept. of Anesthesiology and Intensive Care;

University Hospital, Magdeburg, Deutschland

2Dept. of General, Abdominal, Vascular and Transplant Surgery; University

Hospital, Magdeburg, Deutschland

Background: It is known according to Derogatis et al. that in cancer at

least 50 % of patients have no conspicuous psychological ndings; 30 % of

the patients have adjustment disorders.

In the study by Dombrowsky et al., however, it has been shown that even

below the ICD-10 diagnoses, patients show psychological symptoms.

Adjustment disorders are milder than aective disorders.

Question: Can patients have mental disorders with symptoms that have

not been considered before?

Methods: In preparation for a larger study, 39 patients were interviewed

using “Herschbach’s Progression Anxiety Questionnaire” (short form) in

a pilot study.

Result: In 7 of the 12 questions, the patients had higher mean scores than

the validation sample of 1,000 patients with breast cancer.

Conclusion: Next, it is necessary to investigate what the inuencing

parameters are.

e two most obvious ones are: cancer type and gender.

1. Derogatis LR, Morrow GR, Fetting J, Penman D, Piasetsky S, Schmale

AM, Henrichs M, Carnicke CLM Jr. e prevalence if psychiatric dis-

orders among cancer patients. JAMA 1983;249:751–7.

2. Dombrowsky S, Pfau G, Kretschmar M, Meyer F, Brinkers M.

Depressionen bei somatischen Krankheiten am Beispiel der ischä-

mischen Herzkrankheit und ausgewählter Tumorerkrankungen

mit beträchtlicher Relevanz für Morbidität und Letalität. J Neurol

Neurochir Psychiatr. 2022;23:172–84.

3. Herschbach P, Dankert A, Duran-Atzunger G, Waadt S, Engst-

Hastreiter U, Keller M, Henrich G. Diagnostik von Progredienzangst.

RFB – Wissenschaliche Darstellung A2: Progerdienzangst.

Disclosure Statement: e authors declare no conict of interest.

Paediatric Cancer

109

Medication safety with oral antitumor therapeutics - What is

the need for children?

Phyllis Lensker1,2,3,4; Lisa Cuba1,2,3; Katja Schlichtig2,3; Martin F. Fromm2,3;

Frank Dörje1,3; Markus Metzler3,4

1Pharmacy Department, Erlangen University Hospital, Erlangen, Deutschland

2Institute of Experimental and Clinical Pharmacology and Toxicology,

Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Deutschland

3Comprehensive Cancer Center Erlangen-EMN, Erlangen, Deutschland

4Department of Pediatric and Adolescent Medicine, Erlangen University

Hospital, Erlangen, Deutschland

Background: e therapeutic use of oral antitumor agents is continuously

increasing and is generally associated with convenient administration, both

in adult and pediatric patients. On the other hand, numerous challenges

(e.g., adherence) arise with these therapeutics. e randomized AMBORA

trial (Medication Safety With Oral Antitumor erapy1) demonstrated

highly positive outcomes (e.g., decrease of severe side eects) of an inten-

sied clinical pharmacological/pharmaceutical care program for adult

patients with oral antitumor therapy (OAT). Until now, suitable OAT care

programs for children and adolescents are lacking. We therefore aim to

introduce a comparable, tailored “youngAMBORA” care program.

Methods: A prospective survey for patients, caregivers, and clinicians was

conducted to identify special requirements of pediatric cancer patients.

Dierences in clinical characteristics (e.g., tumor entities and prescribed

OAT) were retrospectively gathered using outpatient clinic data from our

pediatric oncology department between 2017-2022. Subsequently, iden-

tied needs and characteristics of pediatric patients were compared with

the AMBORA cohort.

Results: So far, clinicians (n=32), caregivers (n=40), and patients (n=21)

completed the survey. E.g., swallowing diculties, drug handling, or side

eect reporting were named as particular challenges with oral therapy in

pediatric patients. Furthermore, we identied distinct dierences in onco-

logical entities and used OAT comparing pediatric and adult patients.

Discussion: Based on the knowledge gained in this evaluation, we will adapt

the evidence-based AMBORA program in order to address the special needs

and varying characteristics of pediatric patients. For instance, providing

appropriate information material for children (e.g., an exercise book for

swallowing) could help to improve identied challenges in the future.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 169

Conclusion: A developed demand-adapted “youngAMBORA” program

may improve medication safety in children receiving oral antitumor

therapeutics.

1Dürr et al. JCO 2021.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

363

Inhibition of intercellular communication via gap junctions

renders medulloblastoma cells more susceptible for

cytotoxictherapy

Meng-Chun Hsieh1; Ahmad Melhem1; Hannah Strobel2; Barbara E. F.

Pregler1; Lea L. Friker3; Mike-Andrew Westho2; Torsten Pietsch3;

Hartmut Vatter1; Ulrich Herrlinger4; Andreas Waha3; Anna-Laura Pottho1;

Matthias Schneider1

1Department of Neurosurgery, University Hospital Bonn, Bonn, Deutschland

2Department of Pediatrics and Adolescent Medicine, Ulm University Medical

Center, Ulm, Deutschland

3Department of Neuropathology, University Hospital Bonn, Bonn, Deutschland

4Division of Clinical Neuro-Oncology, Department of Neurology, University

Hospital Bonn, Bonn, Deutschland

Purpose: e discovery of communicative cellular networks has led to a

new understanding of brain tumor biology. Despite the growing knowl-

edge of connexin-43 (Cx43)-based gap junctions (GJ) as key drivers of

malignant intercellular connectivity in several malignant brain tum-

ors, the signicance of GJ in medulloblastoma (MB) remains largely

unknown. In the present study, we explored human MB in regard of

potential GJ-mediated intercellular communication routes and sought for

a potential therapeutic outlook.

Methods: Immunouorescence and Western blot analysis were used to

prove for Cx43-based intercellular GJ expression in group 3 and 4 MB

cell lines (MED8A and D283). Meclofenamate and Tonabersat were used

as clinically-feasible pharmacological GJ-blockers. GJ-inhibiting eects

on cell proliferation and cell death were analyzed using BrdU assay and

ow cytometry. Cellular neighborhood analysis as a surrogate readout for

intercellular morphological connectivity was performed from Real-time

imaging of ZsGreen-tagged medullobastoma cells. CRISPR/Cas9 gene

editing of Cx43 served as a validation tool of cellular eects related to GJ

inhibition.

Results: MED8A and D283 revealed positive intercellular Cx43-based GJ

expression. GJ inhibition was accompanied by antiproliferative eects and

a signicant reduction in the number of neighborhoods per cell. CRISPR/

Cas9 Cx43-knockout demonstrated a synergistic eect for lomustine-in-

duced cell death. Pharmacological GJ inhibition conrmed GJ inhibi-

tion-mediated anti-proliferative eects and profoundly rendered MB cells

more susceptible to lomustine-induced antitumoral eects.

Discussion: MB cells build on GJ as intercellular communication routes.

Further studies will be needed to explore the transcriptional linkage

between therapy failure and GJ-based connectivity.

Conclusions: Inhibition of intercellular GJ renders MB cells more suscep-

tible for lomustine-mediated cytotoxicity. GJ-targeted approaches might

constitute a novel treatment strategy for MB.

Disclosure Statement: e authors declare no conict of interest.

431

Evaluating Pre-HSCT Fitness Levels in Pediatric Cancer

Patients: A Call for Supervised Exercise Interventions

Ronja Beller1; Gabriele Gauß1; Dirk Reinhardt1; Miriam Götte2

1Zentrum für Kinder- und Jugendmedizin, Kinderheilkunde III, Westdeutsches

Tumorzentrum, Universitätsklinikum Essen, Essen, Deutschland

2Westdeutsches Tumorzentrum, Universitätsklinikum Essen, Essen, Deutschland

Background: Pediatric cancer patients preparing for allogenic hematopoi-

etic stem cell transplantation (HSCT) oen endure extensive anti-cancer

therapies. HSCTs pose high risks for life-threatening infections and trans-

plant-related complications. Maintaining physical tness is crucial. e

exploratory ANIMAL Study (DRKS ID: DRKS00019865) assesses eects

of exercise programs on immune reconstitution, motor performance and

psychological parameters, as well as transplantation related outcomes in

HSCT. Here, we present baseline data, focusing on pre-HSCT tness.

Methods: A total of n=22 pediatric patients (≥4 years) were recruited and

assessed upon admission for HSCT. Motor performance parameters were

evaluated and compared to healthy published reference data, including

static balance (1-minute static balance), sit-to-stand (leg muscular endur-

ance), isometric maximum handgrip strength (Jamar dynamometer),

isometric maximum leg extension strength (self-conducted chair with

digital force gauge, Sauter, Germany), and endurance on stationary bicy-

cle ergometer (Steep Ramp Test, SRT).

Result: All patients (5 females, 17 males; age 9.36±4.53; 73% leukemia,

10 relapses) had signicantly lower motor performance parameters com-

pared to age- and gender-specic reference values (static balance: p=.001,

sit-to-stand: p=.019, handgrip strength le: p=.000, handgrip strength

right: p=.001, leg extension strength le: p=.000, leg extension strength

right: p=.002, SRT: p=.000). No adverse events occurred during testing.

Discussion: Pre-HSCT pediatric cancer patients have notably lower t-

ness than age- and gender-specic reference values. is condition may

potentially deteriorate during hospitalization for HSCT and might aect

transplantation outcomes. Future research should explore tailored super-

vised exercise programs before HSCT.

Conclusion: Supervised exercise therapy before HSCT for pediatric

patients is critically needed and indispensable.

Disclosure Statement: e authors declare no conict of interest.

662

Assessing the physical activity of parents whose children have

cancer before and during intensive cancer treatment:

a cross-sectional study

Carolin Ohnmacht; Alexander Puzik

Zentrum für Kinder- und Jugendmedizin Universitätsklinikum Freiburg,

Freiburg, Deutschland

Background: Regular physical activity (PA) is essential for bio-psycho-so-

cial health, while reduced PA during childhood cancer treatment leads to

increased long-term side eects of aected children. Cancer and its treat-

ment determine everyday life of families and parents spend plenty of time

with their children in hospital. us, it can be assumed that the parents’ PA

is signicantly aected during their child’s cancer treatment. Meanwhile,

parents have a pronounced inuence on their children’s PA-behavior. e

study aimed to investigate the parents’ PA and sitting time (ST) before and

during their child’s cancer treatment.

Methods: e study took place monocentrically in the Department of

Pediatric Hematology and Oncology of the Medical Center Freiburg,

Germany. A total of 40 parents were recruited for the study in the

period from september 2021 to february 2022. PA and ST of the parents

were assessed before and during their child’s intensive oncological ther-

apy in a cross-sectional design using the International Physical Activity

Questionnaire – Short Form (IPAQ-SF). Analyses of variance were applied.

Result: e analyses included in total 40 parents (female: n = 31 (77.5%),

male: n = 9 (22.5%) between 18 and 65 years of age. e mean age was 40.1

years. e parents’ PA-levels before diagnosis were in line with reference

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts170

values. During their children’s treatment all dimensions of parents’ daily

PA and the number of MET-minutes of PA per week decreased signif-

icantly (p < 0.001). e greatest reduction in PA was identied during

inpatient stays, with a signicant increase in ST (p < 0.001).

Conclusion: is is the rst study to show that the PA of parents whose

children have cancer signicantly decreases during cancer treatment. As

parents’ PA-behavior signicantly aects their children’s during and even

aer completion of cancer treatment, future exercise programs in pediat-

ric oncology should include parents to reduce inactivity-related long-term

side eects.

Disclosure Statement: e authors declare no conict of interest.

675

The LaNCa Project - New Care Services for Long-Term

Follow-Up after Cancer in Childhood, Adolescence, and

Young Adulthood in Schleswig-Holstein

Franziska Richter1; Anne Ritz1; Ingo Menrath2; Thorsten Langer1;

Hera Becker1; Annemarie Scharnweber3; Jana Vachek3; Maike Schnoor4;

Alexander Katalinic4; Tjorven Stamer5; Jost Steinhäuser5; Nikolas Christian

Cornelius von Bubno6; Jens U. Marquardt2; Judith Gebauer2

1Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Klinik für

Kinder- und Jugendmedizin, Pädiatrische Onkologie und Hämatologie,

Lübeck, Deutschland

2Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Medizinische Klinik I,

Lübeck, Deutschland

3Universität zu Lübeck, Ratzeburger Lübeck, Deutschland

4Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Institut für

Sozialmedizin und Epidemiologie, Ratzeburger Lübeck, Deutschland

5Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Institut für

Allgemeinmedizin, Ratzeburger Lübeck, Deutschland

6Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Klinik für

Hämatologie und Onkologie, Ratzeburger Lübeck, Deutschland

Background: About 80% of children and adolescents diagnosed with can-

cer survive nowadays, but many survivors are faced with long-term eects

from the illness or treatment, with elevated risks throughout their lives.

Providing quality care for this group is crucial. Primary goal of the LaNCa

Project is enhancing long-term follow-up (LTFU) and cross- sector care.

e project includes analyses of patients’ and providers’ needs and pro-

motes guideline-based, interdisciplinary care at a university center tai-

lored to individual risk proles.

Methods: We collected patients’ and providers’ preferences and patients’

care needs using guideline-based interviews and surveys. We created

comprehensive materials such as yers, a website, a doctor’s whitepaper,

and a patient app. Training and video consultations are oered to outpa-

tient doctors and patients. Supporting the transition to adult medicine,

workshops are designed for adolescents and parents, addressing long-

term eects, education, career, psychosocial and legal matters. ese

workshops are oered in group formats, both in-person and online.

Result: Currently, data collection is ongoing and the nal interviews are

being conducted and analyzed. e transition workshops started in July

2023. e concept and process of the study, along with initial survey and

transition workshop results, will be presented at the conference.

Discussion: e patients have a high demand for the transition work-

shops, but the structural prerequisites are not in place and need to be

established rst. Also, poor accessibility and reliability from the patient

side have been observed.

Conclusion: Children and teens who previously had cancer are a sensitive

patient group. LTFU care is vital, and transition workshops are crucial.

Both patients and providers need thorough information. Cross-sector

care and video consultations can greatly enhance care, especially in a

region like Schleswig-Holstein.

e project is supported by the Schleswig-Holstein Care Assurance Fund.

Disclosure Statement: e authors declare no conict of interest.

759

Evaluating the RIST molecular-targeted regimen in

aneuroblastomaspheroidcell culture model

Carina Kaess1; Marie Matthes1; Jonas Gross1; Rebecca Waetzig2;

Tilman Heise1; Selim Corbacioglu1; Gunhild Sommer1

1University Regensburg, Regensburg, Deutschland,

2Friedrich Alexander University, Erlangen, Deutschland

Background: Neuroblastoma is the most common extracranial solid

tumor in childhood. e outcome for patients with high-risk, relapsed,

and refractory neuroblastoma (rNB) remains dismal and novel treatment

strategies are urgently needed. RIST represents a metronomic molecular

targeted treatment strategy, combining Irinotecan and Temozolomide

with the multikinase inhibitor Dasatinib and mTOR inhibitor Rapamycin.

A prospective randomized phase II clinical trial (NCT01467986) is cur-

rently under evaluation. For preclinical drug testing the growth of cancer

cells in form of spheroids compared to monolayer cultures is of advantage

since it reproduces a wide range of avascular solid tumor characteristics,

including 3D architecture and cancer stem cell (CSC) properties.

Methods: Establishment of growth conditions for spheroids in a 96-well

format for 5 NB cell lines. Evaluation of CSC marker expression by

mRNA and protein analysis. Testing the viability of spheroids by apply-

ing luminescence-based assays. Assessment of RNA-binding protein La,

a well-known factor promoting cancer cell plasticity, by tissue microarray

analysis and patients’ data mining.

Result: Compared to monolayer cultures, spheroid cultures not only

showed increased expression of CSC markers CXCR4, NANOG and

BMI1 but also augmented phosphorylation of the NB-associated La pro-

tein (r389). Molecular targeted ‘pre-treatment’ reduced neoplastic sig-

naling, CSC marker expression and the viability of spheroids. e RIST

treatment signicantly decreased the viability of spheroids in all NB cell

lines tested.

Discussion: ese results underscore the importance of the NB spheroid

model for preclinical drug testing in an ecient high-throughput format

which can be valuable to identify more eective treatments for children

with high-risk NB in the future.

Conclusion: e RIST protocol eciently reduced the viability of NB

cells in a preclinical spheroid model despite the presence of increased CSC

properties.

Indication of source:

Kaess C, Matthes M, Gross J, Waetzig R, Heise T, Corbacioglu S, Sommer G.

Evaluating the RIST Molecular-Targeted Regimen in a ree-Dimensional

Neuroblastoma Spheroid Cell Culture Model.Cancers. 2023; 15(6):1749.

https://doi.org/10.3390/cancers15061749.

Disclosure Statement: e authors declare no conict of interest.

873

Development of novel 3D models for pediatric cancer

Alina Wallenwein1; Moni Birkhold1; Steen Gretser2; Elise Gradhand2;

Andreas Weigert3; Margarete Mijatovic3; Meike Vogler1

1Institut für Experimentelle Pädiatrische Hämatologie und Onkologie, Goethe

University, Frankfurt am Main, Deutschland

2Dr. Senckenbergisches Institut für Pathologie und Humangenetik, Goethe

University, Frankfurt am Main, Deutschland

3Institute of Biochemistry I - Pathobiochemistry, Goethe University, Frankfurt

am Main, Deutschland

Background: Rhabdomyosarcoma (RMS) is the most common malignant

so tissue cancer in children. To identify better treatment options, in vitro

models are required that faithfully recapitulate the natural microenviron-

ment in a tumor. However, most research is done in cell lines that have

adapted to growth on plastic as adherent monocultures. In this project we

develop novel 3D spheroid models of pediatric cancer that include pri-

mary patient-derived cells as well as immune and stroma cells. Also, the

eect of apoptosis inducing agents like BH3-mimetics will be investigated

and their ability to increase immune cell killing will be assessed.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 171

Methods: Histological sections from RMS tissues were examined for

immune cell inltration using multiplex imaging. Living primary cells

were obtained from routine dissections and maintained as adherent and

scaold-free spheroid cultures. Immune cells were isolated from PBMCs.

Eects of apoptosis inducing agents and immune therapy were assessed by

microscopy, FACS and CTG Assay.

Result: Preliminary data obtained from with multiplex imaging indicated

limited inltration of T- and NK-cells in RMS tissues. Mixed spheroids

including stromal cells were established using RMS cell lines. Initial

experiments indicate that addition of stromal cells does not prevent

attack by NK cells. Our collection of primary cells currently contains 23

cultures including RMS (n=5) and neuroblastoma (n=3). Treatment of

primary spheroids with BH3-mimetics indicates sensitivity to the BCL-

XL-inhibitors A1331852 and ABT-263 (Navitoclax) as well as to attack by

activated allogenic NK cells.

Discussion: Early results indicate that a combination of apoptosis-

inducing agents like BH3-mimetics and immunotherapy with NK cells

may be a promising approach for the treatment of RMS.

Conclusion: By using primary cell cultures we are currently developing

novel tools for pre-clinical assessment of novel drugs or immunotherapies.

Disclosure Statement: e authors declare no conict of interest.

Palliative Care

Bye Bye PIM - Deprescribing of potentially inappropriate

medications (PIMs) in palliative patients at the end of life

Felia Marie Gradetzke; Dieter Kaag; Matthias Villalobos; Veronika Odin

Thoraxklinik Heidelberg, Universitätsklinikum Heidelberg,

Heidelberg, Deutschland

Background: Palliative patients frequently experience burdensome

polypharmacy. Approaching end of life, benet of some of these drugs

may be questionable and not outweighing its possible harms. As a con-

sequence, deprescribing should be evaluated. e aim of this project was

to reduce the drug burden of palliative care (PC) patients at our 12-bed

palliative care unit, with a focus on potentially inappropriate medications

(PIMs) based on the STOPPFrail and OncPal criteria.

Methods: A team of physician, nurse, clinical pharmacist and 5th year

pharmacy student met for weekly palliative care consults (PCC). Decisions

were made based on laboratory and clinical data, OncPal and STOPPFrail

criteria.

Result: Between June 2021 and Feb. 2023, 146 patients (mean 70 y, 56%

male, main diagnosis: lung cancer) were assessed on the PC unit during

3 time periods overall spanning 24 weeks. Patients received a mean of 2

PCCs (1-8). 32 patients were excluded from analysis due to death or dis-

charge prior to PCC, resulting in 114 patients for evaluation. Among these

patients, 96 patients (84%) received at least one PIM according to men-

tioned criteria. All PIMs were successfully discontinued in 60 (62%), and

partly deprescribed in 19 (20%). 17 (18%) patients remained on all their

PIMs. At admission, patients took a mean of 7.5 drugs (range 2-18); aer

the respective last PCC, this number decreased to 5.3 drugs (range 0-15,

mean reduction 2.2 drugs per patient). e most commonly deprescribed

drugs were supplements (24%), antihypertensives (22%), gastric acid sup-

pressants (12%), and anticoagulants/antithrombotics (12%).

Discussion: In 79 of 96 patients on ≥1 PIM based on OncPal and/or

STOPPFrail criteria, PIMs could be reduced at least partially via weekly

PCCs demonstrating the successful implementation of the project. Future

research should focus on rening deprescribing criteria in STOPPFrail

and OncPal and adding further drug classes not included in the currently

available lists e.g. anticoagulants.

Conclusion: Deprescribing in PC inpatients approaching end of life was

feasible and well tolerated.

Disclosure Statement: e authors declare no conict of interest.

128

Exploratory needs assessment for the conceptualization of an

app for grieving and palliative adolescents and young adults

using the example of an online counseling service

Julia Narosch1; Sarah Salomo2; Cord Spreckelsen3

1Stiftung Hospizdienst Oldenburg, Oldenburg, Deutschland

2Universitätsklinikum Jena, Studiengang eHealth and Communication M.Sc.,

Jena, Deutschland

3Universitätsklinikum Jena, Institut für Medizinische Statistik, Informatik und

Datenwissenschaften, Jena, Deutschland

Background: In the German psychosocial and medical care system hos-

pice and palliative treatments aren’t prioritized. Especially the needs of

adolescents who are aected by loss and illness are oen overlooked in

this context. Digital applications are audience-appropriate for young peo-

ple and could address this gap within the healthcare system. e aim of

this work is to determine if there is a need for a conceptual design of an

app that specically addresses the needs of grieving and palliative adoles-

cents and young adults and which requirements such an app would have

to full.

Methods: To assess needs of users and requirements of a potential app,

two systematic focus group discussions with potential users (n=5) and

experts (n=5) as well as individual interviews (n=8) were conducted.

Using a qualitative content analysis, the collected data was systematically

evaluated and relevant needs as well as app requirements were identied.

Result: e results of the analyses show a clear need for a dedicated app

(n = 14). Identied needs were clustered in four categories: emotional,

social, manageable, informative. For both groups user experience with

the subcategories user engagement and usability was the most frequently

mentioned app requirement. Essential requirements for such an app are

satisfactory user experience and usability. erefore, user-oriented design

processes are recommended.

Discussion: Young people in grieving or palliative situations use digital

spaces by default and expect to be provided with needs-oriented support

options online. Current challenges for the implementation are the high

and unsubsidized development costs and the lack of ecacy research.

Conclusion: Institutions of hospice and palliative care should increase

their use of digital applications if they want to provide need-oriented ser-

vices for young people in the future.

Disclosure Statement: e authors declare no conict of interest.

195

The challenges of proxy reported outcome measures

exemplied by specialist palliative care

Julia Wikert1; Daniela Gesell1; Eva Lehmann-Emele1,2; Claudia Bausewein1;

Farina Hodiamont1

1Department of Palliative Medicine, LMU University Hospital, Munich,

Deutschland

2Department of Palliative Medicine, University Medical Center, Goettingen,

Deutschland

Background: Patient reported outcome measures are increasingly impor-

tant in health care. ey provide a reliable and valid way to assess patients’

situations and track changes over time. Challenges remain in the proxy

use of outcome measures, especially when patients are unable to complete

self-assessments. Proxy versions address this issue and aim at patient-cen-

teredness in symptom/problem assessment. Yet sometimes, burden cannot

fully be assessed by proxies. We aim to explore ‘cannot assess’ responses in

proxy data and associations with patient characteristics.

Methods: Secondary analysis of data from the prospective, cross-sectional

COMPANION study. Proxy data collected by healthcare professionals in

three specialist palliative care settings (palliative care units, palliative care

advisory teams, specialist palliative home care). Descriptive statistics on

‘cannot assess’ values of the Integrated Palliative care Outcome Scale at

the beginning of care episodes, sociodemographic patient characteristics,

palliative care phase, and functional status.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts172

Results: We included 3115 episodes from 29 teams at 12 study sites

across Germany, with mean age of 72 (SD±13) years, 51% female, and

73% with malignant primary diagnosis. Full IPOS could be assessed in

1319/3115 (42%) episodes. Signicantly higher proportions of ‘can-

not assess’ responses were seen in episodes of patients with lower func-

tional status (U=787708.5,Z=-10.209,p<.001) and in the terminal phase

(H(3)=228.035,p=.000).

Discussion: Patients with low functional status and in the terminal phase

are potentially at risk of receiving incomplete assessments. Training for

professionals and further research is required to ensure holistic proxy

assessment of all patients.

Conclusion: Understanding the frequency and reasons for ‘cannot assess’

responses in proxy data is essential for clinical decision-making and facil-

itating comprehensive assessment in oncology.

Funding: G-BA Innovation Fund, no.01VSF18018.

Disclosure Statement: e authors declare the following: Claudia Bausewein:

Präsidentin der Deutschen Gesellscha für Palliativmedizin, Farina Hodiamont:

Vorstandsmitglied der Deutschen Gesellscha für Palliativmedizin.

319

Improving quality of life in patients irradiated for

leptomeningeal carcinomatosis

Kalinka Radlanski1; Daniel Zips2; Dirk Böhmer1

1Charité Universitätsmedizin Berlin, Klinik für Radioonkologie und

Strahlentherapie, Campus Benjamin Franklin, Berlin, Deutschland

2Charité Universitätsmedizin Berlin, Klinik für Radioonkologie und

Strahlentherapie, Berlin, Deutschland

Background: Leptomeningeal carcinomatosis (LC) describes the diuse

metastatic spread of tumor cells in the subarachnoid cavity. It usually

occurs at the end of a disease course and is associated with dismal prog-

nosis. In most cases, therapy of LC is carried out with palliative intent

in patients with a very limited life expectancy (4-6 weeks without treat-

ment, increased to 4-6 months by radiation therapy (RT)). RT is usually

performed by whole brain RT including skull base, lamina cribrosa to 2nd

cervical vertebrum (WBRT-C2) in a single dose fraction of 3 Gray (Gy) up

to a total dose of 30 Gy. erapy planning and follow-up are based on the

assumption that, due to the limited life expectancy, tumor-related disor-

ders take precedence over therapy-associated late eects. However, xeros-

tomia is a radiation-associated side eect known to have a particularly

strong impact on the quality of life (QoL) that has not yet been considered

while carrying out RT of LC.

Methods: Retrospective data analysis of 40 patients who received radio-

therapy for their LC in our department from January 2018 to August

2023. Primary tumor, RT type, time period, and time period between last

RT and time of death/life status at survey were analyzed. In addition, the

mean dose to Gll. parotideae was compared.

Result: 32 patients were suitable for evaluation. e mean time of survival

aer the last day of RT in these patients was 7,6 months (range 4 years-0

days). Six patients showed an exceptionally long course since the last day

of their RT ranging from 1.2 years until even 4 years. On average, the le

Gl. parotidea received 13.35 Gy (range 24.1-2.7 Gy), the right Gl. parot-

idea 17.6 Gy (range 21.3-11.4 Gy).

Conclusion: Patients with LC live on average for 7,6 months aer comple-

tion of RT, and sometimes even considerably longer. During this period,

signicant side eects may develop, which can impair QoL. Currently,

WBRT-C2 does not spare Gll. parotideae by default although this is feasi-

ble in modern radiotherapy. We recommend considering this reasonable

measure to avoid unnecessary impairment of QoL in the palliative setting.

Disclosure Statement: e authors declare no conict of interest.

354

Attitudes of physicians towards standardized palliative care

assessments in oncological inpatient settings

Julia Wikert; Claudia Bausewein; Farina Hodiamont

Department of Palliative Medicine, LMU University Hospital, Munich,

Deutschland

Background: Palliative care needs are complex and their timely identica-

tion is crucial, though challenging. e German Cancer Society demands

the implementation of standardized screening tools for palliative care

needs to facilitate early and appropriate support of burdened patients.

However, the perspective of physicians on oncological hospital wards

towards such standardized tools remains unclear. We aimed to explore

attitudes of oncologists in Germany towards standardized palliative care

assessments.

Methods: Qualitative study throughout Germany with semi-structured

expert interviews and content analysis according to Mayring of verbatim

interview transcripts.

Results: Data collection commenced in 07/23 (so far nine interviews con-

ducted) and will presumably terminate in 10/23. Preliminary results show

that the degree of standardization in the evaluation of palliative care needs

varies notably across oncological wards. Even though oncologists recog-

nize benets of systematic assessments, the evaluation of palliative care

needs is mostly inconsistent and frequently rests on subjective impres-

sions. Concerns preventing the increased use of standardized assessments

include perceived knowledge gaps and time constraints.

Discussion: Oncologists recognize the value of comprehensive assess-

ment including palliative care needs. Implementation of standardized pal-

liative care assessments on oncological wards should include training and

support for professionals, intending to use the respective tools.

Conclusion: e evaluation of palliative care needs on oncological wards

benets from a systematic approach, calling for the use of standardized

assessments. Analysis will be completed by 12/23.

Literature: Mayring, P. (2020). Qualitative content analysis: theoretical

foundation, basic procedures and soware solution. Klagenfurt.

Funding: Verein zur Förderung von Wissenscha und Forschung an der

Medizinischen Fakultät der LMU München.

Disclosure Statement: e authors declare the following: Claudia Bausewein:

Präsidentin der Deutschen Gesellscha für Palliativmedizin; Farina Hodiamont:

Vorstandsmitglied der Deutschen Gesellscha für Palliativmedizin.

385

Screening for specialist palliative care need in oncology:

literature review and toolbox

C. Roch1; Susanne Gahr2; Astrid Schnabel3; Michael Müller4; Paul Sölder4;

Mitra Tewes5; Evelyn Müller4; AG Palliativmedizin Netzwerk Onkologische

Spitzenzentren6

1Interdisciplinary Center for Palliative Medicine & Comprehensive Cancer Center

Mainfranken, University Hospital Würzburg, Würzburg, Deutschland

2Department of Palliative Medicine & Comprehensive Cancer Center, CCC

Erlangen – EMN, University Hospital Erlangen, Friedrich-Alexander-University

Erlangen-Nürnberg, Erlangen, Deutschland

3Leipzig University Cancer Center, Leipzig, Deutschland

4Department of Palliative Medicine, Medical Center- University of Freiburg,

Faculty of Medicine, University of Freiburg, Freiburg, Deutschland

5Department of Palliative Medicine, West German Cancer Center, University

Hospital Essen, University of Duisburg-Essen, Essen, Deutschland

6Koordinationsstelle der AG Palliativmedizin im CCC-Netzwerk, Erlangen,

Deutschland

Background: e identication of patients with incurable cancer requir-

ing specialist palliative care (SPC) has been the subject of research for

many years. In this context, many dierent screening tools have been

developed. Although the objectives are similar, each tool has dierent

characteristics, strengths, and weaknesses. erefore, we aimed to acquire

an overview on screening tools for SPC need suggested for use in oncol-

ogy patients and provide summaries of the literature regarding the most

relevant screening tools.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 173

Methods: Systematic literature review to identify publications on screen-

ing tools in Medline (2012 – 05/2022) and CINAHL (2012-05/2022);

results were screened by two reviewers. Publications reporting on screen-

ing tool development, validation and application were included, if the

screening tool aimed at identifying need for SPC.

Result: In 660 publications, 20 sta-assessed screening tools and ve

patient-reported outcome measures have been suggested for use in

oncology patients. Six of them are generic, 12 indication- and seven

entity-specic. e proposed screening tools include disease-, treatment-

and care-related criteria, as well as patient and family needs. Overall, most

relevant information for choice of screening tools – diagnostic accuracy

to identify SPC need, cut-os based on validation studies or interrater-

reliability in proxy assessment – are reported only for some selected

tools. For the most relevant tools – three PROMs and three sta-assessed

screening tools - that might be considered for use in Germany, summaries

on the state of research regarding aspects of validation and use in practice

are provided in a toolbox.

Discussion: e choice and application of a screening tool for SPC need

should be done with an upfront understanding of the strengths and limi-

tations of each tool.

Conclusion: e toolbox can assist in the selection of an appropriate

screening instrument.

Disclosure Statement: e authors declare the following: Susanne Gahr wird als

Mitarbeiterin der koordinationsstelle der AG Palliativmedizin im CCC-Netzwerk

durch die Deutsche Krebshilfe nanziell unterstützt.

406

Supporting informal caregivers of dying persons: Does an

educational program meet the needs of multiprofessional

hospital ward teams? A qualitative study using participant

observation

Carlotta Jorzick; Karin Oechsle; Carsten Bokemeyer; Anneke Ullrich

Palliative Care Unit, Department of Oncology, Hematology and BMT, University

Medical Center Hamburg-Eppendorf, Hamburg, Deutschland

Purpose: Health care professionals (HCPs) on hospital wards are oen

insecure how to deal with informal caregivers (ICs) of dying persons.

A90-120 min educational program on “Supporting informal caregivers of

dying persons in hospitals” was developed to empower HCPs. e focus is

on successful communication with ICs and HCPs’ self-reection. e pur-

pose of this pilot study was to observe and describe the extent to which the

educational program meets the training needs of HCPs on non- palliative

care wards.

Methods: is qualitative research was based on participant observation

of educational programs with three multiprofessional teams of a univer-

sity hospital (HCPs n=41). Participant observation was conducted using

a priori dened criteria and was recorded in detailed notes. e records

were analyzed using qualitative content analysis.

Results: Behavior and contributions of HCPs conrmed the educational

program in content and elaboration. Despite observed psychological bur-

dens and aggravating factors for the HCPs in context of supporting ICs,

participants showed a great will to improve IC support. Immediate eects

of the educational program were observed on individual and team level,

including validation of the HCPs behavior, identication of shared val-

ues and responsibilities as well as clinical implications for IC support. e

variety of teaching methods proved to be eective, as they addressed dif-

ferent learning needs and led among others to inquiries, increased atten-

tion, and self-reection. e learning impact was supported by the direct

connection to the HCPs emotions and experiences. However, room for

improvement was also identied in terms of shortening factual informa-

tion, rephrasing and including new topics.

Discussion: Topics and teaching methods chosen for the educational

program corresponded to the training needs of hospital ward teams in

dealing with ICs.

Conclusion: Hospital ward teams have a great interest in the adequate

and compassionate care of ICs. HCPs can even benet from a condensed

educational program.

Disclosure Statement: e authors declare no conict of interest.

557

Palliative-specic stressors for health care professionals on

non-palliative care wards and comparison with palliative

carewards

Nikolas Oubaid1; Viola Milke1; Aneta Schieferdecker1; Holger Schulz2;

Sukhvir Kaur3; Sophie Meesters3; Kerstin Kremeike3; Christin Leminski4;

Raymond Voltz3,5,6; Carsten Bokemeyer1; Karin Oechsle1

1Department of Oncology, Hematology and BMT, Palliative Care Unit, University

Medical Center Hamburg-Eppendorf, Hamburg, Deutschland

2Department of Medical Psychology, University Medical Center

Hamburg-Eppendorf, Hamburg, Deutschland

3Department of Palliative Medicine, Faculty of Medicine and University Hospital,

University of Cologne, Köln, Deutschland

4Chair of Quality Development and Evaluation in Rehabilitation, Institute for

Medical Sociology, Health Services Research and Rehabilitation Science, Faculty

of Human Sciences & Faculty of Medicine and University Hospital Cologne,

Köln, Deutschland

5Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO

ABCD), Faculty of Medicine and University Hospital, University of Cologne, Köln,

Deutschland

6Center for Health Services Research (ZVFK), Faculty of Medicine and University

Hospital, University of Cologne, Köln, Deutschland

Purpose: In Germany, most people die in hospitals on non-palliative care

wards (n-PCW). e aim of this study was to identify palliative-specic

stressors perceived by health care professionals (HCP) on n-PCWs, and

compare them with stressors perceived on PCWs. Additionally, data of

general wards (GW) and intensive care units (ICU) were compared.

Methods: Primary data comprised an online sta survey (n=201) on 10

selected n-PCWs of two university hospitals (6 ICUs, n=126; 4 GWs=75).

We assessed 11 palliative-specic stressors (stressors were dichotomized).

Stress score was calculated as an index ranging from 11 (not stressed at

all) to 44 (heavily stressed). Results were compared to secondary data of a

survey on 95 PCWs in Germany (n=873).1

Results: Top 3 stressors on n-PCWs are demand on care for dying patients

(41.3%), unexpected death (38.8%), and special relationship with infor-

mal caregivers (ICs) (36.3%). Top 3 stressors on PCWs are demand on

care for dying patients (51%), special relationship with patient (47.2%)

and accumulation of deaths (42.6%)1. HCPs on ICUs score signicantly

higher in total stress (M=22.5, SD=4.7) than on GWs (M=20.6, SD=4.7,

p=.005). Top 3 stressors on ICUs are demand on care for dying patients

(49.2%), special relationship with ICs (40.5%) and unexpected death

(38.9%). Top 3 stressors on GWs are unexpected death (38.7%), special

relationship with the patient and ICs (each 29.3%).

Discussion: e relationship with the ICs is perceived stressful on

n-PCWs, but not as much on PCWs. HCPs on ICUs are more stressed

than on GWs and dier in the stress intensity over specic stressors. HCPs

on GWs report that the special relationships with the patients and ICs is

perceived as equally stressful.

Conclusion: N-PCWs could benet from measures regarding ICs.

Specically on ICUs, palliative care advisory teams should be included

earlier due to HCPs high stress of demand on care for dying patients.

Indication of source:

1 Müller, M et al. Wie viel Tod verträgt das Team? Schmerz 23, 600–608 (2009).

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts174

565

Dealing with systemic therapies at the end of life

in cancer patients

Henrik Schulte-Hürmann1; Julius Hettich2; Dirk Arnold3; Georgia Schilling3

1Semmelweis University of Medicine, Asklepios Campus Hamburg, Hamburg,

Deutschland

2Akershus Universitetssykehus, Nordbyhagen, Norwegen

3Asklepios Tumorzentrum Hamburg, AK Altona, Hamburg, Deutschland

Background: e decision to continue systemic therapy at the end of life

must be weighed against the potential negative impact of treatment-re-

lated toxicities. e aim of this study was to investigate the patterns of use

and initiation of systemic therapy at the end of life.

Methods: is retrospective, monocentric study consecutively included

all patients with a cancer diagnosis who died in the palliative care unit of

the Asklepios Tumorzentrum Hamburg, AK Altona between 11/2018 and

07/2023. e interval between the last administration of systemic therapy

and the end of life (30 days, 3 months, >3 months) as well as initiation of

the last line of therapy before death were investigated. Dierences in the

administration of chemo-, immuno-, and targeted therapy were of interest.

Result: 357 patients with hematologic malignancies (14%) or solid malig-

nant tumors (86%) were included. 34% of patients received no further sys-

temic therapy. 40% received chemo-, 7% targeted- and 6% immunotherapy

as their nal therapy. An additional 13% received a combination of these

drug classes at the end of life. Initiation of a new line of therapy within the

last 3 months of life was documented in 31% of all patients; in 10%, the new

treatment was initiated only one month before death. 52% received sys-

temic therapy in the last 3 months of life, with 35% continuing it until the

nal 30 days. ere was no signicant dierence between the types of ther-

apy regardless of their last use before the end of life, duration, or initiation.

Discussion: In 31% of treated patients, a new line of therapy was started

within the last 3 months of life. is may be due to a lack of tools to

improve patient selection or a lack of interdisciplinary discussion in

tumor boards. Observational studies and registries are warranted to iden-

tify and evaluate such criteria.

Conclusion: Our study showed that 52% of patients already under pal-

liative care received systemic therapy in the last 3 months of life. ese

results indicate that we need tools to be more considerate and selective

with the administration of systemic therapies at the end of life.

Disclosure Statement: e authors declare no conict of interest.

569

Psychological burden and supportive care needs of informal

caregivers in specialist palliative care: study protocol for a

multicenter prospective longitudinal study

Clara Haufschild1; Anne Daubmann2; Karin Oechsle1; Holger Schulz3;

Antonia Zapf2; Carsten Bokemeyer1; Anneke Ullrich1

1Palliative Care Unit, Department of Oncology, Hematology and BMT, University

Medical Center Hamburg-Eppendorf, Hamburg, Deutschland

2Institute of Medical Biometry and Epidemiology, University Medical Center

Hamburg-Eppendorf, Hamburg, Deutschland

3Department of Medical Psychology, University Medical Center Hamburg-

Eppendorf, Hamburg, Deutschland

Purpose: is abstract introduces a study protocol investigating psycho-

logical burden and supportive care needs of informal caregivers (ICs)

of patients at the beginning of and in the trajectory of specialist pal-

liative care. is 3-year study pursues two objectives: Firstly, to weekly

assess ICs’ psychological burden and supportive care needs, focusing

on possible course types and inuencing factors. Secondly, to validate a

newly developed short multidimensional screening instrument for ICs

(HAM-CAREPAL-8).

Methods: is research employs a multicenter prospective longitudinal

design. A sample of ICs (N=689) will be recruited from 16 in- and outpa-

tient specialist palliative care facilities across Germany. Data will be col-

lected using the HAM-CAREPAL-8 and a set of validated and standardized

questionnaires at the initiation of specialist palliative care and weekly for

up to 10 weeks. To minimize the burden of repeated questioning on ICs, a

design with planned missing values is implemented for the follow-up ques-

tionnaires (Planned Missing Data Design). e analysis of the longitudinal

data will be performed using Growth Mixture Models (GMM).

Results: e conference contribution will outline the study protocol and

will include reections on the ongoing research process, particularly

focusing on strategies used to overcome barriers well known in research

with vulnerable populations.

Discussion: is well powered study is expected to yield insights in course

types and inuencing factors of psychological burden and supportive care

needs of ICs during specialist palliative care. If the HAM-CAREPAL-8

proves valid, a tool would be available that would make it possible to clas-

sify ICs in clinical daily practice with regard to dierent risk proles of

multidimensional burden.

Conclusion: With successful implementation, we expect that the nd-

ings will have signicant implications for palliative care providers and

policy-makers helping them recognize and address the ICs’ unique chal-

lenges in daily cancer care. e study is funded by the German Cancer

Aid (70115093).

Disclosure Statement: e authors declare no conict of interest.

572

Improving the dying situation on non-palliative care wards:

Evaluation of the participants’ perspectives on a bottom-up

approach

Viola Milke1; Nikolas Oubaid1; Aneta Schieferdecker1; Anneke Ullrich1;

Holger Schulz2; Sukhvir Kaur3; Sophie Meesters3; Kerstin Kremeike3;

Christin Leminski4; Raymond Voltz3,5,6; Carsten Bokemeyer1; Karin Oechsle1

1Department of Oncology, Hematology and BMT, Palliative Care Unit, University

Medical Center Hamburg-Eppendorf, Hamburg, Deutschland

2Department of Medical Psychology, University Medical Center Hamburg-

Eppendorf, Hamburg, Deutschland

3Department of Palliative Medicine, Faculty of Medicine and University Hospital,

University of Cologne, Köln, Deutschland

4Chair of Quality Development and Evaluation in Rehabilitation, Institute for

Medical Sociology, Health Services Research and Rehabilitation Science, Faculty

of Human Sciences & Faculty of Medicine and University Hospital Cologne,

Köln, Deutschland

5Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO

ABCD), Faculty of Medicine and University Hospital, University of Cologne, Köln,

Deutschland

6Center for Health Services Research (ZVFK), Faculty of Medicine and University

Hospital, University of Cologne, Köln, Deutschland

Purpose: In the “Dying in Hospitals - Optimization of Care in the Dying

Phase” project (Funded by the “Innovations-Fond”), multi-professional

working groups (WGs) of health care professionals (HCPs) were estab-

lished on ten non-specialist palliative care wards at two university hos-

pitals. In these researcher-supported WGs, wards-specic measures to

optimize care in the dying phase were developed by using a bottom-up

approach. e experience and satisfaction of the HPCs with the WGs and

the implementation of the measures was evaluated.

Methods: Aer the WG process, an online survey was sent to all HCPs

who participated in the WGs in January 2023. e survey consisted of 17

closed, self-developed questions on a 3-point Likert scale rating the HCPs’

satisfaction with the content, outcomes of the WGs and the implemen-

tation on the wards. We used descriptive statistics to analyze the results.

Results: A total of 69 WG meetings (mean: 6.9, range: 5-12) were held

with 3-6 HPCs in mean per meeting and a duration of 1-1.5h. Of 78 eligi-

ble HCPs, 48 responded to the survey (63%): 52% nurses, 23% physicians

and 25% psychosocial HPCs. e majority (16 of 17 items) of questions

were rated positively (range: 55-91%). e most valued aspect was the

opportunity to contribute own opinions/topics in the WG process (91%).

Most HCPs would participate again in such WGs (77%) and would rec-

ommend HCPs of other wards to develop own interventions to improve

care in the dying phase (80%). Satisfaction with the developed measures

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 175

for their wards was 66%. However, 55% reported that implementing the

measures at the ward level had worked well.

Discussion: e results show that implementing a bottom-up approach to

the development of measures by HPCs is possible and positively rated, but

may also face implementation challenges.

Conclusion: e positive ratings and satisfaction with the researcher-

supported WG process indicate the use of a bottom-up strategy to develop

interventions for care in the dying phase on non-specialist palliative

carewards.

Disclosure Statement: e authors declare no conict of interest.

637

Study protocol of a longitudinal mixed-methods study

exploring psychological burden, quality of life and support

needs of informal caregivers during non-specialist palliative

care in a Comprehensive Cancer Center (CCC)

Lena Hagedorn; Anneke Ullrich; Tabea Theißen; Carsten Bokemeyer;

Karin Oechsle

Palliative Care Unit, Department of Oncology, Hematology and BMT, University

Medical Center Hamburg-Eppendorf, Hamburg, Deutschland

Purpose: Informal caregivers (ICs) are crucial for the well-being of

advanced cancer patients. However, their needs are not always recognized

in daily oncology practice and there is no strategy for early identication

of highly burdened ICs during non-specialist palliative care as part of

cancer care. e aim of this mixed-methods longitudinal cohort study is

to determine the psychological burden, quality of life (QoL) and support

needs of ICs within cancer care in a CCC.

Methods: A quantitative study part involving N≥260 adult ICs collects

data using self-report questionnaires on psychological burden, QoL and

support needs within 8 weeks aer the patient’s initial diagnosis of incur-

able cancer, follow-ups during cancer treatment every 3 months over a

maximum of 3 years or until the patient‘s death, as well as 3-6 months

aer death (if occurred). Questionnaires include validated and reliable

instruments. Data is analyzed using descriptive and inferential statis-

tics. Simultaneous, a qualitative study part is conducted consisting of

semi-structured interviews with - depending on data saturation - about

n=20 ICs each at all three time points. Grounded theory is used to analyze

qualitative data.

Results: e data collection phase of this 5-year study with a recruitment

phase of 36 months was initiated in April 2023 including cooperation

partners from the CCC network. Qualitative analysis takes place itera-

tively while conducting the interviews.

Discussion: is study will be one of the rst to reveal systematic data on

psychological burden, QoL and support needs of ICs during cancer care

(non-specialist palliative care) in CCCs during the course of advanced

cancer - from rst diagnosis until bereavement. Furthermore, the longitu-

dinal design will provide reference of changes over time when patients are

treated for advanced cancer in a CCC.

Conclusion: Detailed knowledge about psychological burden, QoL and

support needs of ICs of advanced cancer patients could be relevant for

improving cancer care in future. e study is funded by the Hamburg

Cancer Society.

Disclosure Statement: e authors declare no conict of interest.

670

Electronic PROM in home-based palliative care in Germany:

feasibility and perceived value

Katerina Hriskova1; Isabel Burner-Fritsch1; Stefanie Kolmhuber1;

Christina Ramsenthaler2; Claudia Bausewein1

1Klinik und Poliklinik für Palliativmedizin, LMU Klinikum, Ludwig-Maximilians-

Universität München, München, Deutschland

2ZHAW Gesundheit, Winterthur, Schweiz

Purpose: To pilot the use of eIPOS (electronic version of the Integrated

Palliative Outcome Scale) in Specialised Palliative Home Care (SPHC); to

explore patients’ and health care professionals (HCP) views on it.

Methods: Quasi-experimental mixed methods design - intervention

group: patients completed eIPOS on their laptop/tablet repeatedly. i)

IPOS-values were transferred directly into the digital patient record, ii)

qualitative interviews (patients), focus groups (HCPs). Descriptive and

framework analyses. A symptom/problem was dened as prevalent when

patients reported at least “moderate” burden.

Result: 82 SPHC-patients used eIPOS (22.7% recruitment rate, 87% with

incurable cancer, mean age 68.5 y; 49% female) and submitted overall 470

eIPOS forms (average 5.7/pat.; range 0-15). Missing values in submitted

eIPOS were low (<5%). Most prevalent symptoms: “lack of energy,” “poor

mobility,” and “family burden”. Using eIPOS leads patients to reection on

their own situation and gives them a feeling of empowerment. However,

some described it as stressful due to confrontation with their own situ-

ation/ symptom burden. HCPs indicated that eIPOS supports holistic

assessment, detection of unrecognised symptom burden, and improved

communication.

Discussion: Unlike traditional data collection (text-based documenta-

tion), information from electronic patient-reported outcome measure-

ment (ePROM) is computable, immediately available, can be continuously

updated and easily tracked longitudinally. As SPHC is for palliative patients

with complex symptom burden, only few could use eIPOS. Nevertheless,

ePROM supports care by identifying undetected symptoms, detecting

changes, and improving communication between HCP and patients.

is was also conrmed in our study, especially in the detection of psy-

chosocial symptom burden.

Conclusion: HCPs see potential of eIPOS in palliative home care, patients

describe predominantly positive eects. However, independent use is

challenging for many SPHC patients. erefore, informal caregivers

should be involved in its use.

Disclosure Statement: e authors declare no conict of interest.

733

Standardized training for recruitment of informal caregivers

in palliative care research

Anneke Ullrich; Carsten Bokemeyer; Karin Oechsle

Palliative Care Unit, Department of Oncology, Hematology and BMT, University

Medical Center Hamburg-Eppendorf, Hamburg, Deutschland

Purpose: Many palliative care studies fail to recruit adequately and on

schedule. erefore, strategies to support recruitment of informal caregiv-

ers (ICs) of patients with life-limiting illness for research are needed. We

discuss the development, piloting, and preliminary assessment of a novel

training to improve researchers’ positive attitudes and communication

skills in recruiting ICs in palliative care research.

Methods: We developed a 90 min evidence-based, standardized training

guided by adult learning principles. e program was implemented by the

palliative care research group specialized in IC research in a university

hospital. Preliminary assessment comprised detailed notes of the trainings

including oral feedback from the trainees.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts176

Results: e training content includes 1) ethical considerations, 2) evi-

dence on ICs’ motives to participate in research, 3) potential barriers for

recruitment focusing on IC factors, “gatekeeping”, and ethical concerns, 4)

key procedures of recruiting, and 5) communication with ICs. Teaching

methods used include theoretical input, reective learning, and short case

vignettes helping to apply theory to practice. To enhance successful com-

munication, standardized wording is provided (e.g. regarding thoughtful

messaging to make research relevant). Until now, 21 researchers with var-

ying experience (doctoral candidates, student assistants, psychosocial and

clinical researchers) participated in three trainings. Trainees reported to

feel more positive and condent about IC recruitment. e mix of research

experience and professional background among trainees enhanced the

learning. Trainees’ feedback included the usefulness of practicing through

role-plays and a pocket-sized laminated card with key information and

standardized wording.

Discussion: Based on the assessments, the training materials will be fur-

ther developed, re-piloted, and manualized.

Conclusion: A carefully craed recruitment may be eective. Our experi-

ence with piloting the standardized training indicates the benets of such

an approach.

Disclosure Statement: e authors declare no conict of interest.

737

Development of an educational program for multiprofessional

hospital ward teams to improve informal caregiver support

during patients‘ last days of life

Anneke Ullrich; Carlotta Jorzick; Carsten Bokemeyer; Karin Oechsle

Palliative Care Unit, Department of Oncology, Hematology and BMT, University

Medical Center Hamburg-Eppendorf, Hamburg, Deutschland

Purpose: e aim of the study is developing, piloting, and assessing an

educational program for healthcare professionals (HCPs) to improve their

knowledge, attitudes, and communication skills in caring for informal

caregivers (ICs) of patients dying in hospitals.

Methods: is conference contribution describes the development of the

90-120 min program “Supporting informal caregivers of dying persons

in hospitals” tailored to the specic learning needs of multiprofessional

teams on non-palliative care wards. e program was developed for being

implemented in hospitals by specialist palliative care services (SPCS).

Results: e eory of Planned Behavior and adult learning principles,

emphasizing reective and interactive learning, guided the development.

e components of the program were identied by literature review,

an expert panel of palliative care and psychosocial specialists, and key

informants (e.g. leading nurses). Key features include the implementation

as a multiprofessional, ward-based, in-service intervention provided by

SPCS. e contents aimed to improve HCPs’ competencies in the fol-

lowing broad areas: 1) attitudes towards caring for ICs confronted with

death, 2) informing ICs about the dying process, 3) exploring ICs’ intense

emotions and supporting them, 4) managing challenging communica-

tion situations, and 5) personal awareness and self-care. Selected teaching

methods include theoretical input, group discussions, reective learning,

and short case vignettes. Trainees are provided with a pocket-sized lami-

nated card, helping them to apply their knowledge to practice.

Discussion: is very condensed, evidence-based educational program

addresses main elements of IC care during patients’ last days of life. If the

pilot implementation and assessment proves to be successful, a prelimi-

nary program would be available to enhance the competencies of HCPs

on non-palliative care wards with regard to IC care.

Conclusion: We anticipate that the program will positively inuence

planned behavior and will empower HCPs to better support ICs.

Disclosure Statement: e authors declare no conict of interest.

738

Social support experience during bereavement: Does

expected versus unexpected loss make a dierence?

Anneke Ullrich1; Birgit Wul2; Laura Schäfsmeier1; Jan Herzog1;

Carsten Bokemeyer1; Klaus Püschel2; Karin Oechsle1

1Palliative Care Unit, Department of Oncology, Hematology and BMT, University

Medical Center Hamburg-Eppendorf, Hamburg, Deutschland

2Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf,

Hamburg, Deutschland

Purpose: Although social support is supposed to be helpful, negative

interactions with others may impede its positive eects during bereave-

ment. is cross-sectional study investigated the positive and nega-

tive experiences of social support among bereaved next-of-kin (BNK)

6 months to 6 years aer an expected or unexpected loss of a beloved

person.

Methods: A total of N=377 BNK (n=205 bereaved by expected deaths

during palliative care, n=172 by sudden out-of-hospital deaths) com-

pleted questionnaires on social support (ISSS-8; scales: Positive Support

and Detrimental Interactions, both ranging from 0=lowest to 16=high-

est) and psychological burden. Tests for mean dierences were used to

compare the social support experience aer expected vs. unexpected loss.

Predictors of the social support experience were examined by multiple

regression analysis, including the expectancy of death.

Results: An average of 3.1 years post loss, the mean Positive Support score

was 10.8 of 16 (SD=3.8) and the mean Detrimental Support score was 2.5

of 16 (SD=2.9). About 36% of BNK (n=128) experienced no detrimen-

tal interactions (score: 0) and 10% (n=37) reported the highest level of

positive support (score: 16). We did not nd any dierences in the social

support experiences between BNK aected by expected vs. unexpected

loss. Predictors of higher levels of positive support were a non-spousal

relationship to the deceased (ß=.211, ß<.001) and lower depressive symp-

toms (ß=-.350, p<.001). Higher levels of detrimental interactions were

predicted by elevated symptoms of post-traumatic stress disorder (PTSD;

ß=.245, p=.002) and complicated grief (ß=.298, p<.001).

Discussion: Detrimental interactions stemming from social networks are

a relevant issue in BNK. However, they occur independently of the expec-

tancy of death, but are associated with bereavement-related psychological

burden.

Conclusion: Bereavement support should address negative social interac-

tions, particularly in BNK aected by symptoms of complicated grief and

PTSD, regardless of whether the loss was expected or not.

Disclosure Statement: e authors declare no conict of interest.

833

Far advanced cancer (FAC) patients’ point-of-view on

decision-making and end-of-life interaction

Isabel Kruschel1; Cordula Gebel1; Katsiaryna Laryionava2;

Rebecca Boekels2; Marc Cinci2; Eva Winkler2; Ulrich Wedding1

1Department of Internal Medicine II (Palliative Care), University of Jena, Jena,

Deutschland

2Department of Medical Oncology, National Center for Tumor Diseases (NCT),

Programme for Ethics and Patient-oriented Care in Oncology; Heidelberg

University Hospital, Heidelberg, Deutschland

Background: In patients with far advanced cancer (FAC) decisions on

anti-cancer treatment and/or initiation of palliative care are frequent and

challenging balancing medical information with patients’ values and pref-

erences. We assess patients’ perception of decisional conict, participation

in decision-making and their impact on patient-physician interaction in

FAC. Additionally, we explore how sociodemographic data inuence deci-

sional conict and end-of-life discussions.

Methods: Using data of the rst measurement point from a study on par-

ticipatory decision-making, FAC patients completed a multidimensional

questionnaire aer consultation with the oncologist following imaging

for treatment choice. Self- reported sociodemographic data and validated

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 177

scales measuring decisional conict, decision-making participation, life

quality (QL) vs length (LL) preferences and patient-physician interaction

satisfaction were analyzed descriptively and inferentially.

Result: 56 patients with FAC participated. Most consultations (89%)

yielded decisions about treatment and the majority in continuing

anti-cancer therapy. From the patients’ point of view, the decisional con-

ict was low (mean 27.6, SD 19.1), Patients’ involvement in decision-mak-

ing is negatively correlated with decisional conict (r=0.54, p=0.00) and

positively correlated with satisfaction of patient-physician interaction

(r=0.70, p=0.00). OL and LL showed no correlation. Sociodemographic

data showed no notable decision-making inuence in our analysis.

Discussion: ere is a lack of analysis regarding criteria relevant to FAC

patients in decision-making scenarios. Findings highlight decisional con-

icts’ role in patient participation and satisfaction with patient-physician

interaction.

Conclusion: Awareness of these simple measured values could improve

decision-making by inuencing the style and content of patient-physician

interaction.

Disclosure Statement: e authors declare no conict of interest.

842

Creating and implementing a decision aid for far advanced

cancer patients in an outpatient setting: Perspectives of

health care professionals and valuable lessons learned

Rebecca Boekels1; Katsiaryna Laryionava1; Jan Schildmann2;

Michel Wensing3; Ulrich Wedding4; Bastian Surmann5; Katja Mehlis1;

Cordula Gebel4; Marc Cinci1; Katja Krug3; Eva Winkler1

1Nationales Centrum für Tumorerkrankungen – NCT, Heidelberg, Deutschland

2Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland

3Universitätsklinikum Heidelberg - Medizinische Fakultät, Heidelberg,

Deutschland

4Klinik für Innere Medizin II - Palliativmedizin, Jena, Deutschland

5Health Economics and Health Care Management, Bielefeld, Deutschland

Background: Decision aids (DAs) can be a valuable tool for patients with

far advanced cancer in complex decision-making situations. Building on

the ndings of a DA implementation study, this analysis aims to shed light

on barriers for implementation from the perspective of health care pro-

viders, especially oncologists, and to identify problem areas that require

special attention.

Methods: is study is based on two data sets from related research proj-

ects, consisting of n=29 semi-structured interviews with oncologists and

three focus groups with members of various health professions. In addi-

tion, n=5 semi-structured interviews with oncologists following the use of

the DA in the doctor-patient interview were included. e data thus col-

lected were analyzed for content and supplemented with insights gained

during the design and implementation of the DA.

Result: Two central themes emerged from our ndings: 1) Standardizing

the use of DA conicts with adapting it to the individual needs of patients.

2) Factors that contribute to the successful implementation of DA, includ-

ing senior physician support, palliative care training, and supportive

organisational conditions.

Discussion: e study highlights divergent opinions on the value of stan-

dardizing the use of DA in cancer end-of-life care. Some participants

advocate standardized guidelines to ensure consistent use of DA, while

others emphasize the need for adaptability to individual patient contexts.

A two-part generic DA is presented to balance standardization and indi-

vidual patient needs.

Conclusion: Among the hurdles to be overcome before practical applica-

tion, lack of support from senior doctors and lack of training stand out as

they can be specically addressed. e use of a two-part DA for patients

with far advanced cancer in oncology represents an innovative approach to

resolving the conict between individualization and standardization as it is

applicable to all cancer types while oering the opportunity to be individu-

ally tailored to the patient’s needs and readiness to discuss end-of-life issues.

Disclosure Statement: e authors declare no conict of interest.

896

Caring together for advanced breast cancer: Digital

networking and support for caring relatives of people

suering from breast cancer in the last phase of life

Sara Marquard

Universität Osnabrück, Osnabrück, Deutschland

Background: Relatives of people suering from metastatic breast cancer

have a high need for support in terms of accompanying the person with

the disease as well as their own psychological, social and organizational

needs. Digitally support is hardly available and suer from qualitative

deciencies.

Methods: Based on a scoping review on the needs of family members, a

standardized online survey as well as individual interviews with family

members were conducted. e standardized data were analyzed descrip-

tively. e analysis of the qualitative data was carried out content-analyti-

cally. e results were analyzed together with a digital agency and various

experts in order to derive target group-specic conclusions for the devel-

opment of a digitally supported socio-technical support system.

Result: Relatives feel burdened in the support of women suering from

metastatic breast cancer. New responsibilities and burdens arise for the

persons living in the same home. is involves new or changed roles as

well as relationship problems. Family members have unmet needs, mostly

information decits. Specically, there is uncertainty about the near and

distant future and a high need for information about disease-specic top-

ics, social aspects and relationship aspects. Stabilizing factors include sup-

port networks that are perceived as both present and digital.

Discussion: A specic app must provide support services for family

members and relatives (information, counseling, case management), take

into account specic phases of the process (diagnosis, progression of the

disease, dying process, survival aer death) and provide specic topics

(knowledge of care, relationships/interaction, body experience, help mix,

work and care in uncertainty), depending on the experience of stress.

Conclusion: For the subsequent implementation study, this means

developing an app based on the identied technical, conceptual and con-

tent requirements that is able to provide adequate, evidence-based and

low-threshold support to residents and members.

Funding: e project was funded by the BMBF.

Disclosure Statement: e authors declare no conict of interest.

Primary and Secondary Prevention

190

Does an overall unhealthy life-style reduce the ecacy of

a brief alcohol intervention? Findings from a randomized

controlled trial in general hospital patients

Filipa Krolo-Wicovsky1; Sophie Baumann2; Anika Tiede1; Gallus Bischof3;

Beate Gaertner4; Ulrich John5; Jennis Freyer-Adam1

1Universitätsmedizin Greifswald, Institut für Medizinische Psychologie,

Greifswald, Deutschland

2Universitätsmedizin Greifswald, Institut für Community Medicine, Abteilung

Methoden der Community Medicine, Greifswald, Deutschland

3Universität zu Lübeck, Klinik für Psychiatrie und Psychotherapie, Lübeck,

Deutschland

4Robert-Koch-Institut, Abteilung für Epidemiologie und

Gesundheitsmonitoring, Berlin, Deutschland

5Universitätsmedizin Greifswald, Institut für Community Medicine, Abteilung für

Prävenstionsforschung und Sozialmedizin, Greifswald, Deutschland

Background: At-risk alcohol use, a leading risk factor for cancer devel-

opment and mortality, is oen accompanied by other modiable behav-

ioural cancer risk factors (CRFs), i.e. tobacco smoking, physical inactivity

or overweight. Brief alcohol interventions can reduce alcohol use and

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts178

improve health. Little is known on whether their ecacy diers by the

participants’ overall lifestyle. We investigated if the number of CRFs mod-

erates in-person and computer-based brief alcohol intervention ecacy in

general hospital patients with at-risk alcohol use.

Methods: As part of a German Cancer Aid funded randomized controlled

trial, 961 general hospital patients with at-risk alcohol use aged 18-64

years were allocated to in-person counselling, computer-generated indi-

vidual feedback and assessment only. Both intervention groups included

contacts at baseline, 1 and 3 months later. Aer 6, 12, 18 and 24 months,

self-reported alcohol use per day was assessed as outcome. e CRF sum

score was tested as a moderator of alcohol use using likelihood ratio test

and a latent growth curve model.

Result: Overall, CRF sum score did not moderate ecacy signicantly

(p = .179). However, participants with 1 more CRF (n = 275) reduced

alcohol use more strongly aer computer-based intervention compared

to assessment only at month 6 (p = .032). ose with all 4 CRFs (n = 174)

reduced alcohol use more strongly aer computer-based intervention up

to month 24 (ps <.004) and aer in-person intervention up to month 18

(ps <.044) compared to assessment only.

Discussion: Both computer-based and in-person BAI were especially

ecacious in reducing alcohol use among participants with all 4 behav-

ioural CRFs. One helpful behaviour change mechanism may have been

the highly individualized, strictly theory-driven and motivation tailored

intervention.

Conclusion: Proactive, theory-driven, and highly individualized BAI,

regardless of delivery mode, has the potential of being particularly eec-

tive in those most in need of intervention, i.e. for general hospital patients

with the unhealthiest lifestyle.

Disclosure Statement: e authors declare no conict of interest.

283

iSCREEN – a digital questionnaire regarding familial breast

and ovarian cancer

Nora Amirpour-Mehrhof1; Katharina Klein2,3; Christina Mangum4;

Benedikt Lotz1; Shirin Saadat Sarmadi1; Stephen Schüürhuis5;

Simone Wesselmann3; Ste Stegen1,6; Jenny Katharina Wagner1;

Jens-Uwe Blohmer1; Friederike Kendel2; Markus Feufel4; Dorothee Speiser1

1Charité – Universitätsmedizin Berlin, Zentrum Familiärer Brust- und

Eierstockkrebs, Klinik für Gynäkologie mit Brustzentrum, Berlin, Deutschland

2Charité – Universitätsmedizin Berlin, Department of Gender in Medicine, Berlin,

Deutschland

3Deutsche Krebsgesellschaft e.V., Bereich Zertizierung, Berlin, Deutschland

4Technische Universität Berlin, Department of Psychology and Ergonomics (IPA),

Division of Ergonomics, Berlin, Deutschland

5Charité – Universitätsmedizin Berlin, Institute of Biometry and Clinical

Epidemiology, Berlin, Deutschland

6BRCA-Netzwerk e.V., Hilfe bei familiären Krebserkrankungen, Bonn,

Deutschland

Background: Around one third of breast cancer patients have a famil-

ial cancer burden. Advances in screening programs, genetic analysis, and

risk-reducing surgery enhance the ability to prevent hereditary breast, and

ovarian cancer. To benet from all these opportunities, a familial cancer

burden must be identied as early as possible. is identication process

relies on the use of a checklist provided by the German Cancer Society

(GCS, Deutsche Krebsgesellscha e. V.). e completion and interpre-

tation of this checklist is reserved for medical professionals. e active

involvement of the patients themselves in a digital approach can simplify

the process. e study aimed to assess iSCREEN’s accuracy in comparison

to the personal interviews by the medical professionals, as well as its usa-

bility and psychological impact.

Methods: As part of the GBA-funded project dVP_FAM (01NVF20002),

iSCREEN was developed transforming the GCS-checklist into a digital

patient questionnaire. e evaluation of the data is based on the GCS-

algorithm and the results are sent digitally to the physician with the

patients’ consent. An exploratory study with upstream in-silico analysis

was executed. First, 200 pedigrees were evaluated using iSCREEN and

the results were compared with the GCS-checklist to verify accuracy.

Aerwards, 160 patients lled out iSCREEN, followed by a personal inter-

view. e usability analysis focused on factors such as completion time,

comprehensibility, and preferred assessment method.

Result: e study revealed that iSCREEN identied all patients with

a familial cancer burden. Study participants reported the questions in

iSCREEN to be easily understandable and had no problem completing

the questionnaire. Additionally, the majority expressed interest in using

iSCREEN in the future. No negative psychological eect was observed.

Discussion & Conclusion: e digital questionnaire iSCREEN seems

to be well suited to identify individuals with a familial cancer burden in

gynecological practices. A CE mark will be obtained for regular use of

iSCREEN in standard care.

Disclosure Statement: e authors declare no conict of interest.

594

OnkoRiskNET: A multicenter, interdisciplinary,

telemedicine-based model to improve care for patients

with a genetic tumor risk syndrome

Johanna Tecklenburg1; Beate Vajen1; Caroline Scholz1;

Christian Landgraf1; Paula Memenga2; Eva Baumann2; Sarah Wöling3;

Judith Böthig3; Evelin Schröck3,4,5,6,7; Clara Dubois8; Sonja Gscheidle8;

Matthias Arnold8; Anke Katharina Bergmann1; Schlegelberger Brigitte1

1Department of Human Genetics, Hannover Medical School, Hannover,

Deutschland

2Department of Journalism and Communication Research, Hanover University

of Music, Drama and Media, Hannover, Deutschland

3Institute for Human Genetics, University Hospital Carl Gustav Carus Dresden,

Dresden, Deutschland

4ERN GENTURIS, Hereditary Cancer Syndrome Center Dresden, Dresden,

Deutschland

5National Center for Tumor Diseases Dresden (NCT/UCC), Germany: German

Cancer Research Cen-ter (DKFZ), Heidelberg, Deutschland

6Faculty of Medicine and University Hospital Carl Gustav Carus at TU Dresden,

German Cancer Consortium (DKTK), Dresden, Deutschland

7Max Planck Institute of Molecular Cell Biology and Genetics, Dresden,

Deutschland

8inav – Private Institute for Applied Health Services Research GmbH, Berlin,

Deutschland

Background: Genetic tumor risk syndromes account for at least 10% of

newly diagnosed cases of cancer in Germany each year. e diagnosis

of a genetic tumor risk syndrome enables personalized therapy and pre-

vention, as well as the identication of other aected family members.

However, they are oen overlooked. OnkoRiskNET aims to bridge this

care gap.

Methods: e study is led by the Department of Human Genetics at

Hannover Medical School and will be running up to 2025. 26 oncology

practices are participating in the project forming a network between

practicing oncologists and human genetics specialists in Lower Saxony

and Saxony. Patients will receive routine care or the new care approach

with structured care pathways, case management, and telemedical genetic

counseling. Randomization is conducted at the practice level using a

stepped wedge design. With a mixed-methods approach we will assess:

(1) Uptake of human genetic counseling; (2) Patient satisfaction and psy-

chological distress; (3) Factors inuencing the acceptance and experience

of telemedical genetic counseling; (4) Satisfaction of physicians with the

care model; (5) Cost-eectiveness.

Result: Within the rst 16 months, the study has enrolled 377 out of 756

planned oncology index patients - due to the stepped wedge design 291 in

the control group and 82 in the intervention group. Preliminary analyses

reveal that the uptake of genetic counseling was 46% in the control group

compared to 96% in the intervention group.

Discussion: Our preliminary results suggest that the new model of care

leads to an improved uptake of genetic counseling and testing in patients

with a suspected genetic tumor risk syndrome.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 179

Conclusion: Initial results show that the new care model facilitates access

to genetic diagnostics, helps to overcome barriers in identifying patients

with a genetic tumor risk syndrome and thus improves the care of these

patients.

Disclosure Statement: e authors declare no conict of interest. OnkoRiskNET

is funded by a grant from the Federal Joint Committee of the Federal Republic of

Germany.

699

Improving students’ knowledge about cancer

Winja Weber; Karen Herold; Julia Geulen; Karin Greulich-Bode;

Susanne Weg-Remers

Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Deutschland

Background: In order to eectively prevent cancer, it is important to

educate adolescents about relevant cancer risk factors and possibilities of

prevention. is requires eective interventions – particularly in school

settings, as this may compensate for social disadvantages. us, we have

developed scientically based teaching materials, among them materials

on carcinogenesis, and on risk factors, including human papillomavirus

(HPV). e latter is particularly important, as vaccination can eectively

prevent HPV-induced cancers at young age. e aim of this study was to

investigate whether teachers’ use of the materials in class could eectively

improve students’ knowledge.

Methods: We conducted an intervention study in a pretest-posttest design

with students in grades 6 to 13. Knowledge about the respective content

of the teaching materials was measured using multiple-choice questions.

We used paper-pencil questionnaires both once before and twice (imme-

diately aerwards and four weeks later) aer a teacher had a lesson based

on these materials. In addition, we collected socio-demographic data and

a perception of the materials (e.g. not interesting – interesting). A total of

N = 85 students participated in all three survey waves for carcinogenesis

and N = 119 for HPV.

Result: e students evaluated both materials positively, perceiving the

topics as particularly interesting and important. Repeated-measures anal-

yses of variance showed that both materials signicantly improved the

knowledge of the students. Post-hoc comparisons with Bonferroni cor-

rection showed signicant increases in knowledge from the rst to the

second as well as to the third measurement time points.

Discussion/Conclusion: e use of scientically based teaching materials

helps to improve children’s and young people’s knowledge of carcinogene-

sis, and cancer prevention by HPV vaccination eectively and sustainably.

is may increase vaccination rate and contribute to the prevention of

cancer in the long term.

Disclosure Statement: e authors declare no conict of interest.

843

Can brief alcohol interventions among general hospital

patients produce benecial spill-over eects on other

cancer-risk related behaviors?

Jennis Freyer-Adam1,2; Filipa Krolo-Wicovsky1,2; Anika Tiede1,2;

Sophie Baumann3; Gallus Bischof4; Beate Gaertner5; Ulrich John2,6

1Institute for Medical Psychology, University Medicine Greifswald, Greifswald,

Deutschland

2German Center for Cardiovascular Research, Greifswald, Deutschland

3Department for Methods in Community Medicine, Institute of Community

Medicine, University Medicine Greifswald, Greifswald, Deutschland

4Department of Psychiatry and Psychotherapy, Medical University of Lübeck,

Lübeck, Deutschland

5Department of Epidemiology and Health Monitoring, Robert Koch Institute

Berlin, Berlin, Deutschland

6Department of Prevention Research and Social Medicine, Institute of

Community Medicine, University Medicine Greifswald, Greifswald, Deutschland

Background: About half of the general adult population report multiple

cancer-risk related behaviors. E.g. among adults who drink alcohol at risk,

about 90% also report tobacco smoking, insucient physical inactivity

and/ or overweight. Little is known about potential spill-over eects of

behavior change interventions that address alcohol use on other can-

cer-risk related behaviors. e aim was to investigate whether eective

computer-based and in-person brief alcohol interventions may reduce

various cancer-risk related behaviors among general hospital patients

with at-risk alcohol use.

Methods: rough systematic screening, 961 18-64 year old patients with

non-dependent at-risk alcohol use were identied (75% male, 53% tobacco

smokers); and allocated to three study groups: 1) computer-based written

feedback, 2) in-person motivational interviewing based counseling and 3)

treatment as usual. Both alcohol interventions were tailored to the indi-

vidual motivational stage of change and were delivered directly on the

ward; and 1 and 3 months later. Secondary outcomes were self-reported

tobacco smoking, servings of vegetable and fruit per day, physical activity

and body mass index aer 6, 12, 18 and 24 months. Adjusted latent growth

models were calculated. Funding was provided by the German Cancer Aid

(108376, 109737, 110676, 110543, 111346, 70114206, 70115012).

Result: Aer 2 years, and compared to assessment only, the in-person

intervention resulted in benecial eects on body mass index (p<0.05),

and by trend on physical activity (p=0.05). e computer-based interven-

tion resulted in reduced smoking among smokers aer 6 months (p<0.05)

and by trend in lower gain of body mass index aer 24 months (p=0.05).

Discussion: Proactive, theory-driven, highly individualized in-person

and computer-based brief alcohol interventions may also reduce other

single cancer-risk related behaviors.

Conclusion: For long-term and comprehensive cancer-risk related behav-

ior change, interventions addressing all co-occurring cancer-risk related

behaviors may be needed.

Disclosure Statement: e authors declare no conict of interest.

855

Vitamin in prevention of cancer: ction or truth

Andre Rotmann

Privatpraxis Dr. Rotmann, Frankfurt am Main, Deutschland

Background: Cancer, is an unavoidable risk in life that aects nearly every

second individual in industrialized countries. However, a low vitaminD

status is a risk in particular for cancers of colon, prostate, and breast.

Vitamin D intake could reduce cancer mortality in the population by

12percent - provided the vitamin is taken daily. is was the result of an

evaluation of 14 studies of the highest quality conducted at the German

Cancer Research Center with a total of almost 105,000 participants. is

oral presentation want to present this data and show how this easy tool

could be integrated in the complementary oncology.e aim of this sys-

tematic review and meta-analysis of randomized controlled trials (RCTs)

was to summarize and evaluate the eects of vitamin D3 supplementation

(VID3S) on cancer outcome.

Methods: I searched PubMed, Web of Science and Cochrane databases.

Result: When all 14 studies were pooled, no statistically signicant results

emerged. However, when the studies were divided according to whether

vitamin D3 was taken daily in a low dose* or in higher doses administered

at longer intervals, a large dierence was seen. In the four studies with the

infrequent hogher doses, there was no eect on cancer mortality. In contrast,

in the summary of the ten studies with daily dosing, the researchers deter-

mined a statistically signicant twelve percent reduction in cancer mortality.

Conclusion: is work underlines the great potential of vitamin D3

administration in the prevention of cancer deaths. Regular intake at low

doses* is associated with almost negligible risk and very low cost.” e

Check of the Vitamin D Levels is easy and makeable. e Integration in

Daily work is mandatory.

Source: Kuznia S. et al.: Ecacy of vitamin D3 supplementation on cancer mor-

tality: Systematic review and individual patient data meta-analysis of randomised

controlled trials. Ageing Res Rev. 2023, DOI: 10.1016/j.arr.2023.101923.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts180

859

Cluster Randomized Trial: Sun Protection Intervention

‘Clever in Sun and Shade for Preschools’—Eectiveness and

Dissemination

Nadja Knauthe1; Vera Fieber1; Melanie Glausch1; Eckhard W. Breitbart2;

Martin Bornhäuser1,3; Friederike Stölzel4

1National Center for Tumor Diseases Dresden (NCT/UCC), Dresden, Deutschland

2Arbeitsgemeinschaft Dermatologische Prävention (ADP) e. V., Buxtehude,

Deutschland

3Universitätsklinikum Carl Gustav Carus Dresden, Medizinische Klinik und

Poliklinik I, Dresden, Deutschland

4University Cancer Center Schleswig-Holstein (UCCSH), Kiel, Deutschland

Background: Skin cancer is one of the most common types of cancer

and UV radiation is one of the main risk factors. erefore, sun protec-

tion, especially in childhood, is strongly recommended. We examined

the eectiveness of the ‘Clever in Sun and Shade for Preschools’ program

(CLEVER) in promoting sun protection behavior among preschool sta

(trial registration: DRKS00023468) and describe its dissemination.

Methods: Within a cluster randomized trial with 24 preschools (n=273

sta members) stating a high need for sun protection measures, an

educational workshop for preschool sta and a project kit with materials

applicable in preschool groups was provided.

Result: Sta members of preschools taking part in CLEVER report signif-

icantly stronger sun protection behavior to avoid the sun (eect size [ES]

0.70, 95% condence interval [CI] 0.04 0.71, p<0.05) and less perceived

impediments to avoid the sun (ES −0.56, CI −0.82 −0.17, p<0.01) aer 12

months as well as higher self-ecacy to avoid the sun (ES 1.09, CI 0.39

1.07, p<0.001) and to use sunscreen (ES 0.71, CI 0.03 0.88, p<0.05) aer

1 month. Compared to the control group, there was no signicant eect

on sunscreen use and further psychosocial outcomes. e eectiveness of

CLEVER may be underrated due to a high drop-out rate.

Conclusion: Within three years, an enhanced free-of-charge program kit,

including a media-based workshop and materials, had reached over 4000

preschools, i.e., 7.1% of all daycare centers in Germany. e results show

that CLEVER can strengthen sun protection, oer high-quality informa-

tion at low cost, and is easily disseminable.

Indication of source:

Seidel N, Fieber V, Breitbart EW, Bornhäuser M, Stölzel F. Cluster Randomized

Trial: Sun Protection Intervention ‘Clever in Sun and Shade for Preschools’-

Eectiveness and Dissemination. Children (Basel). 2021 Jul 28;8(8):651.

doi: 10.3390/children8080651. PMID: 34438542; PMCID: PMC8391804.

Disclosure Statement: e authors declare no conict of interest.

920

Increased UV burden in daycare centers through climate

change

Vera Fieber1; Friederike Stölzel2; Melanie Glausch1; Eckhard W. Breitbart3;

Nadja Knauthe1

1National Center for Tumor Diseases Dresden (NCT/UCC), Dresden, Deutschland

2University Cancer Center Schleswig-Holstein (UCCSH), Kiel, Deutschland

3Arbeitsgemeinschaft Dermatologische Prävention (ADP) e. V., Buxtehude,

Deutschland

Background: Health consequences of climate change are increasingly in

the focus of research. In educational settings, professionals are challenged

to protect themselves and the children entrusted to them from negative

eects. Children are particularly vulnerable to health impacts of climate

change, such as skin damage caused by increased UV exposure.

Methods: e authors conducted a nationwide online survey in

November/December 2022 to determine the extent to which educational

professionals perceive health stresses due to climate change in recent

years. Participants were recruited using convenience sampling.

Result: N=4879 educators participated in the survey; n=3791 records

(median age=40-49 years; 93% female) met the criteria for completeness.

Heat and UV radiation were found to be particularly stressful: 70.9% and

43.1%, respectively, felt strongly exposed to these factors, followed by

allergens, extreme weather events, psychological stress, infections, and air

pollutants. A moderate percentage reported heat protection (65.4%) and

UV protection (76.8%) measures. More than 40% would like to have more

free information material and further training.

Discussion: e high number of participants indicates the relevance

of health-related climate change impacts in early childhood education

institutions and the need for various prevention measures, especially to

reduce exposure to heat and UV radiation. e sample was representative

for preschool educators in Germany in terms of gender and supporting

institutions, but not in terms of age and federal state.

Conclusion: Increasing awareness of the impacts of climate change oers

opportunities for the prevention of UV-related skin damage and skin can-

cer. For example, the free program “Clever in Sonne und Schatten für Kitas”

(Clever in Sun and Shade for Preschools) can help institutions raise awareness

among educators, parents and children about appropriate UV protection.

Disclosure Statement: e authors declare no conict of interest.

Psychooncology

Exploring the requirements for preparing, delivering and

following-up breaking bad news conversations in pediatric

oncology: results of a participatory group delphi

Theresia Krieger; Kerstin Dittmer; Isabel Hamm; Frank Vitinius

Universität zu Köln, Köln, Deutschland

Background: In pediatric oncology, breaking bad news (BBN) is perceived

as particularly challenging. Failure to address the specic needs of pediat-

ric patients/children and their relatives can negatively impact on both the

BBN recipients and providers (e.g., physicians). Pediatric-specic BBN

support tools lack in Germany. e project OKRA – Orientation Compass

for BBN in the pediatric oncology – aims to develop a tool to prepare,

guide and further support BBN providers. We present the rst phase of a

two-phase project, funded by the German Leukemia Research Aid.

Methods: Fourteen organizations were actively engaged in this PGD.

Aer exploring the emerging themes around the categories preparing,

delivering, and following up a BBN the OKRA theses were formulated.

Result: ORKA’s rst phase consists of a Participatory Group Delphi

(PGD). Multiperspective knowledge was systematically generated through

interviews, focus group discussions and surveys. Qualitative thematic

analyses are applied, supported by MAXQDA. Four groups participated:

(1) experts from own experiences (organizations representatives on behalf

of aected children and their parents), (2) BBN providers from pediatric

oncological teams and representatives of national professional societies,

(3) psychosocial supporters (e.g., counselors), and (4) health system

researchers. Following ve steps, this PGD culminated in the formulation

of theses for the high-level management of BBN.

Discussion: A systematically designed tool for BBN preparation, delivery,

and follow-up in pediatric oncology is of outstanding interest. For provid-

ers, it may reduce emotional distress and lead to improved quality of care.

For recipients, a well performed BBN may impact on their ability to cope

with the disease and increase psychosocial well-being.

Conclusion: Exploring the detailed requirements from multiple perspec-

tives leads to a comprehensive understanding of the issues to be addressed

around the BBN. e PGD results in pediatric oncology-specic theses

that build the foundation for the BBN guiding tool OKRA.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 181

A Portray of Available Information on Cancer-related Fatigue

on German Healthcare Institutions’ Websites: Quality,

Credibility, Usability, and Readability of Information

Anna S. Wagner1; Marlena Milzer2,3; Karen Steindorf 2; Senta Kiermeier1;

Martina Schmidt2; Imad Maatouk1

1Universitätsklinikum Würzburg, Medizinische Klinik II für Innere Medizin,

Abteilung Psychosomatik, Psychotherapie, Psychoonkologie, Würzburg,

Deutschland

2Deutsche Krebsforschungszentrum und Nationales Tumor Zentrum,

Heidelberg, Deutschland

3Universität Heidelberg, Heidelberg, Deutschland

Background: Recent surveys revealed that cancer patients feel poorly

informed about cancer-related fatigue (CRF). Considering the idea of

patient empowerment by providing information this study aimed to

portray available information on CRF on German healthcare institution

websites.

Methods: Based on general website quality criteria we developed a website

rating tool comprising 18 items. Descriptive analyses, Kruskal Wallis tests

and corresponding post-hoc tests comparing rating sum scores between

institution groups were performed.

Results: Websites of 281 systematically compiled German cancer centers,

hospitals, and other healthcare institutions regularly treating cancer

patients were included in the rating. CRF was introduced on 21.9% and

detailed information was provided on 27.9% of the websites. Information

material was linked on 9.2% and treatment oers were provided on 21.6%

of the websites. Rating sum scores diered between institution groups

(p < .001) with Comprehensive Cancer Centers scoring signicantly

higher than the others. Contents were overall dicult to read.

Discussion: Institutional websites could serve as trusted information

sources for patients aected by CRF. However, information on CRF and

references to appropriate treatment oers were not included on most of

the German healthcare institutions’ websites. If provided, information was

mostly not as easily understandable as the American Medical Association

recommends for patient-centred text.

Conclusion: Provision of information on institutional websites was sparse

with CRF being addressed on less than half of them. Healthcare institu-

tions in cancer care may need to improve their websites so that they at least

contain an introduction of CRF and refer patients further to external web-

pages or information booklets with already existing, high- quality infor-

mation. Naming contact persons may help linking patients to providers.

Disclosure Statement: e authors declare no conict of interest.

127

Barriers to an eective patient-physician communication

about cancer-related fatigue

Marlena Milzer1,2,3; Anna S. Wagner4; Martina Schmidt1,2; Imad Maatouk4;

Silke Hermann5; Senta Kiermeier4; Karen Steindorf1,2

1Division of Physical Activity, Prevention and Cancer, German Cancer Research

Center (DKFZ) Heidelberg, Heidelberg, Deutschland

2National Center for Tumor Diseases (NCT), NCT Heidelberg, a partnership

between DKFZ and University Medical Center Heidelberg, Heidelberg,

Deutschland

3Medical Faculty, University of Heidelberg, Heidelberg, Deutschland

4Section of Psychosomatic Medicine, Psychotherapy and Psychooncology,

Department of Internal Medicine II, Julius-Maximilian-University, Wuerzburg,

Deutschland

5Epidemiological Cancer Registry of Baden-Württemberg, German Cancer

Research Center (DKFZ), Heidelberg, Deutschland

Background: Cancer-related fatigue is a frequent symptom impair-

ing patients’ quality of life and daily functioning. However, it is oen

unrecognized and represents a common unmet need for supportive care.

In this study, we investigated cancer patients’ views on the patient-physi-

cian communication about fatigue.

Methods: e multimodal LIFT project included a survey of 1,179 cancer

patients ve months aer diagnosis. Patients were systematically recruited

through the Cancer Registry of Baden-Wuerttemberg. e survey included

questions on fatigue management, communication barriers, and perceived

quality of patient-physician communication about fatigue. Descriptive sta-

tistics and logistic regression analyses were used for analysis.

Results: Fiy-six percent of the sample was female, and the most common

cancer types were breast (26%) and colorectal cancer (16%). Half of the

patients were never asked about exhaustion by their physicians, 74% were

not informed about fatigue, and only 13% received a systematic fatigue

screening. Two-thirds of the patients perceived communication barriers,

such as not knowing who to turn to (39%), time constraints (31%), the belief

that physicians consider fatigue unimportant (26%) and the fear of being

perceived as weak (22%). A large number of patients rated the quality of

patient-physician communication about fatigue as unsatisfactory.

Discussion: Due to various structural, patient-related and physician-

related barriers fatigue is oen not addressed between patients and physi-

cians. When a conversation about fatigue does occur, patients experience

the quality of communication as insucient.

Conclusion: Improving patient-physician communication about fatigue

is a necessary step to overcome shortcomings in fatigue management.

erefore, physicians should regularly address fatigue, conduct screen-

ings, and provide information, as suggested in guidelines. A reective

communication style might further encourage patients to seek a dialogue

about fatigue and raise their questions.

Disclosure Statement: e authors declare no conict of interest.

170

Eects of Chemotherapy and Radiotherapy in Mothers

withGynecologic Tumors on the Mother-Child Relationship

Theresa Engel1; Antonia Rabe2; Achim Wöckel1; Elisabeth Jentschke2

1University Hospital Würzburg (UKW), Department of Gynecology, Würzburg,

Deutschland

2University Hospital Würzburg (UKW), Department of Psychooncology,

Würzburg, Deutschland

Background: e prevalence of psychological distress in mothers with

gynecologic tumors is high. e aim of this study is to identify these wom-

en’s needs and possible entry points for support by interdisciplinary sta.

Methods: We interviewed women with gynecological tumors, who

received therapy and had underage children in a semi-structured manner

and performed a qualitative content analysis (Kuckartz). e following

hypotheses were tested: 1) e burden of chemo- and/or radiotherapy in

mothers with gynecological tumors has an impact on the mother-child

relationship (MCR), which can be both negative and positive. 2.1)

Support regarding children from clinical sta has a positive eect on both

the MCR and the mother’s quality of life (QoL). 2.2) Mothers who are

more open with their children about their illness have a higher QoL.

Results: e category-based evaluation of 29 interviews showed six central

categories: experience of the diagnosis, mothering aer diagnosis, MCR,

communication, environment and psychooncological care. Most women

indicated a change in the MCR, most of them a positive one. Of those

women who received psychooncological care a majority noticed a positive

change in the MCR. On one hand, patients with a lower QoL received

psycho-oncological care more frequently and communicated more openly

with their children – compared to mothers with a higher QoL. On the

other hand, the group of women with higher QoL communicated slightly

more open than not in their own group.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts182

Discussion/Conclusion: e women noted general decits in care, par-

ticularly regarding the challenges of mothers with cancer, such as com-

munication, childcare, and running the household. Although a simple

generalization of the statements falls short, our study can help raise aware-

ness of the specic stress-related burdens of mothers with cancer among

clinical sta to reduce some of their emotional stress. ere seems to be

a high correlation between QoL and openness about the disease which

needs further investigation.

Disclosure Statement: e authors declare no conict of interest.

178

Online music therapy group intervention for patients

receiving cancer therapy - intervention development and

feasibility testing

Miriam Grapp; Charlotte Flock; Till Johannes Bugaj

Univeristätsklinik Heidelberg, Abteilung für Allgemeine Innere Medizin und

Psychosomatik, Heidelberg, Deutschland

Background: Various reviews show signicant positive eects of music

therapy interventions in terms of improvement of anxiety, depressive

symptoms, and pain. Music therapy group interventions are of particular

importance, as they have not only the music therapy-specic eects, but

also the special group therapy eect factors.

Methods: We developed supportive and resource-oriented music therapy

group intervention for patients under tumor therapy. e unique charac-

teristic of this intervention is that it is oered online and video-based due

to the situational particularities caused by the corona pandemic as well as

due to the limited physical mobility of many patients under tumor ther-

apy. e focus of the intervention is on receptive music therapy, i.e. active

listening to music. e contents of the music therapy group intervention

include: (1) using music as a resource, (2) learning about one’s own musi-

cal biography (3) dealing with fears, worries and other stressful feelings,

and (4) music-induced relaxation and mindfulness.

Result: Currently, this innovative group concept is being evaluated in a

pilot study, especially with regard to the feasibility and acceptance of the

online intervention. e group concept and rst results of the pilot study

will be presented at the congress.

Discussion: While on an international perspective music therapy care in

the eld of oncological acute therapy is well established, there are still few

comparable interventions in Germany. One possible reason for this could

be that in Germany music therapy is anchored above all in oncological

rehabilitation and in the treatment of highly palliative patients, but has so

far hardly found its way into the acute sector due to the oen challenging

conditions.

Conclusion: In case of proven feasibility and acceptability the online

music therapy group intervention could be an innovative care option,

especially for physically impaired patients for whom face-to-face services

are too burdensome.

Disclosure Statement: e authors declare no conict of interest.

185

Therapeutic Alliance in Psycho-Oncology – A Systematic

Review

Charlotte Flock; Miriam Grapp; Rahel Oldsen;

Hans-Christoph Friederich; Till Johannes Bugaj

Universitätsklinikum Heidelberg, Klinik für Allgemeine Innere Medizin und

Psychosomatik, Heidelberg, Deutschland

Purpose: erapeutic Alliance (TA) has been established as a crucial suc-

cess factor of psychotherapy. Despite compelling hints towards a signi-

cant role of TA in psycho-oncology, seemingly little research exists. us,

an overview is aimed to be reached by systematically identifying (1) key

characteristics of TA in psycho-oncological care and (2) concepts related

to TA in psycho-oncological care settings.

Methods: PRISMA-reporting guidelines were followed and the review

was preregistered (PROSPERO). PubMed, PsycInfo, and Web of Science

were systematically searched for empirical studies looking upon adult

cancer patients receiving psycho-oncological care, and TA. Quality assess-

ment was undertaken using the Mixed Methods Appraisal Tool. Extracted

data were synthesized in tabular and narrative form.

Result: Out of 4.647 search results, 24 quantitative, qualitative, and

mixed-methods studies were included in this review. Characteristics of

studies, interventions and samples were heterogenic. Overall high TA

scores were reported by patients. Favourable associations with distress

and well-being and mixed results for further outcome variables and com-

pliance were detected. For associations with (baseline) patient- and ther-

apist characteristics mixed results were revealed. Synthesis of qualitative

evidence pointed at a particularity of TA in psycho-oncology, e.g., patients

experiencing TA with their psycho-oncologist in the context of other

patient-provider relationships experienced due to the disease.

Discussion: is unique insight into the eld revealed a diverse and

quickly developing research eld. First hints towards the ecacy and par-

ticularity of TA in psycho-oncologic settings are delivered. Meanwhile it

is subject to limitations such as the great heterogeneity of studies and evi-

dence, hindering clear interpretations.

Conclusion: Results encourage to further focus on TA in psycho-oncol-

ogy, in research as well as in clinical practice - also in settings outside

traditional face-to-face contacts.

Disclosure Statement: e authors declare no conict of interest.

204

“The Ulm Treasure Chest” - a multimedia resource for dealing

with existential distress

Sarah Krämer; Klaus Hönig

Uniklinik Ulm Abt Psychosomatische Medizin und Psychotherapie, Ulm,

Deutschland

Background: e “Ulmer Treasure Chest” (UTC) is a free psycho-onco-

logical oering for individuals with palliative cancer who are parents of

minor children. It allows them to create an interview-based “Life Film”

that captures biographical highlights, as well as wishes, advice, and mes-

sages for special moments. ese can then be passed on as a realistic

keepsake to their children and partners. Additionally, this oering aims

to support those aected in dealing with their existential burden, helping

them clarify their values and needs, draw a positive life balance, and shape

their farewell in a self-determined and dignied manner.

Methods: e exploration of existential topics is conducted using a

structured guide based on a meaning-oriented intervention specically

focused on preserving dignity (Dignity therapy). Films are created that

allow the bereaved to experience the deceased from multiple dimensions.

Result: Since 2022 10 lms were produced. Scientic evaluation started

2023. Funding is obtained through donations and third-party sources.

Public awareness has been achieved through internet and social media

presence, as well as newspaper articles, radio and television interviews.

Participant evaluations regarding the psycho-oncological preparation

using the guide, the lming location, styling, and on-site support from the

team have been consistently positive.

Discussion: Key positive aspects may include improved quality of life,

enhanced palliative treatment planning through increased awareness of

personal values and needs, acceptance of approaching mortality, positive

eects on partners, and a lasting “living” memory of the parent. Challenges

to be discussed include the nancial and logistical sustainability of the

oering, as well as the hurdles related to confronting one’s own mortality.

Conclusion: e creation of a lm as a personal legacy, based on targeted

psycho-oncological exploration of existential burdens, holds various ben-

ets for patients, close people, and healthcare providers.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 183

210

Posttraumatic growth after cancer: a large-scale study of its

subdimensions and determinants

Patricia Blickle1,2; Martina Schmidt1; Karen Steindorf1

1Deutsches Krebsforschungszentrum (DKFZ), Abteilung Bewegung,

Präventionsforschung und Krebs, Heidelberg, Deutschland

2Universität Heidelberg, Medizinische Fakultät, Heidelberg, Deutschland

Background: e positive psychological change experienced aer a chal-

lenging life event, such as cancer, is dened as posttraumatic growth (PTG)

and has recently received increasing attention in cancer research. We

investigated the extent and longitudinal predictors of PTG in disease-free

cancer survivors.

Methods: Individuals with dierent types of cancer were included. Four

years aer diagnosis (t1), all ve subdimensions of PTG were assessed

using the 21-item PTG inventory: appreciation of life, relation to others,

personal strengths, new possibilities and spiritual change. Fatigue was

measured with the EORTC QLQ-FA12, pain with the EORTC QLQ-C30

pain items and emotional distress with the Patient Health Questionnaire

(PHQ-4) two years aer diagnosis (t0). Descriptive and multiple regres-

sion analyses were used.

Result: e mean age of the analyzed 1,316 cancer survivors (51.4%

female) was 67.2 years (SD=11.1) at t1. Regarding the extent of PTG, the

most positive developments were experienced in the PTG subdimension

appreciation of life (median (Q1-Q3) = 47.0% (20.0%-66.7%)), whereas

the subdimension spiritual change was the least pronounced domain

(10.0% (0.0%-40.0%)). Higher fatigue, pain and emotional distress were

longitudinal, but non-linear predictors of higher long-term PTG. Other

determinants of higher PTG were younger age, female gender and receipt

of chemotherapy. e better survivors felt informed about fatigue at t0,

the higher their PTG scores were.

Discussion: Many cancer survivors perceive positive personal changes

even years aer a traumatic cancer event, especially young people and

women. Higher PTG appears to be longitudinally associated with higher

levels of common cancer side eects.

Conclusion: Cancer survivors who are poorly educated about their symp-

toms are less likely to perceive positive changes, suggesting that psychoed-

ucational services may be helpful. Further research is needed on the role

of individuals knowledge in contributing to PTG.

Disclosure Statement: e authors declare no conict of interest.

213

Dreaming in Cancer Patients and their Partners - A

Quantitative Study with Dyadic Data

Sarah Salomo1; Tabea Hackl1; Birk Hagemeyer2; Jutta Hübner1

1Universitätsklinikum Jena, Klinik für Innere Medizin II, Hämatologie und

Internistische Onkologie, Jena, Deutschland

2Friedrich-Schiller-Universität Jena, Lehrstuhl für Persönlichkeitspsychologie

und Psychologische Diagnostik, Jena, Deutschland

Background: Sleep disturbances are a common side eect of cancer or its

therapy. ey can persist beyond the duration of therapy, impairing the

patient’s quality of life, but also inuencing the quality of sleep/life of their

intimate partners. Closely related to sleep quality, but so far hardly sys-

tematically studied in cancer patients, is the subjective dream experience.

Since dreaming is as well connected to quality of life, the aim of this study

was a quantitative analysis of the dream experience in cancer patients and

their partners with focus on possible interdependencies.

Methods: A cross-sectional study was conducted with 101 cancer patients

and their partners from an oncology day clinic and patient training ses-

sions. Participants completed questionnaires assessing demographic data,

disease-related information, treatment-related information, dream expe-

riences, sleep quality, and life satisfaction. Actor-partner-interdependence

models (APIM) were used to analyze the data.

Result: Both cancer patients and partners reported a signicant decrease

in sleep quality since the cancer diagnosis and were categorized as “poor

sleepers”. Dream stability was signicantly correlated with life satisfaction

in patients, while positive and negative dream emotions were signicantly

correlated with life satisfaction in partners. Dream intensity indicated an

interdependency between patients and their partners in terms that very

intensive dreams of the intimate partner seem to negatively eect life sat-

isfaction in patients.

Discussion: Dream experiences has an impact on life satisfaction beyond

sleep quality in cancer patients as well as their partners. e results sug-

gest a possible interdependence between dream experiences of partners

and patients.

Conclusion: e study highlights the importance of considering dream

experiences as potential factors inuencing the quality of life in can-

cer patients and emphasizes the role of partners in understanding their

inuence.

Disclosure Statement: e authors declare no conict of interest.

221

Professional Grief Among Healthcare Professionals in Cancer

Care: A Scoping Review

Svenja Wandke1,2; Hannah Führes1; Mareike Thomas1; Klaus Lang3;

Martin Härter1; Karin Oechsle4; Isabelle Scholl1

1Universitätsklinikum Hamburg-Eppendorf, Zentrum für Psychosoziale Medizin,

Institut und Poliklinik für Medizinische Psychologie, Hamburg, Deutschland

2Universitätsklinikum Hamburg-Eppendorf, II. Medizinische Klinik und Poliklinik

(Onkologie, Hämatologie, Knochenmarktransplantation mit Abteilung für

Pneumologie), Hamburg, Deutschland

3Psychotherapeutische Praxis, München, Deutschland

4Universitätsklinikum Hamburg-Eppendorf, Palliativmedizin, Klinik und

Poliklinik für Onkologie, Hämatologie und KMT, Hamburg, Deutschland

Background: As cancer remains one of the leading global causes of

death, healthcare professionals (HCPs) in cancer care routinely encoun-

ter patients’ deaths. While they oen establish close bonds with their

patients, limited evidence exists on their grief over patient loss, termed

professional grief (PG). is scoping review aimed at identifying key

aspects, research gaps, and the frequency and intensity of PG of HCPs

working in cancer care.

Methods: We applied the Arksey and O’Malley framework1. e primary

search covered three databases (PUBMED, PsycINFO and PSYNDEX).

Empirical studies on HCPs’ reactions towards or coping with patient

deaths were eligible for inclusion. Two reviewers independently screened

titles and abstracts, and assessed full texts for eligibility.

Results: Aer screening 2,184 records and assessing 269 full texts for eli-

gibility, 30 articles were included. Studies predominantly originated from

North America and Israel and limited quantitative data became evident.

Within the cancer care context, HCPs demonstrated various grief symp-

toms, common ones like sadness and crying, along with distinct facets

such as feelings of guilt. Grief frequency varied highly. However, a distinct

denition of PG as well as a common terminology were notably absent.

Discussion: e lack of consensus on a concept denition and terminol-

ogy for PG weakens the reliability of existing evidence. Additionally, this

review accentuates the signicance of exploring PG across diverse cultural

contexts and occupational settings.

Conclusion: Future research should focus on rening the conceptualiza-

tion and measurement of PG, enabling more precise insights in diverse

cultural and occupational backgrounds. A need emerges for designing and

assessing tailored interventions, oering support to HCPs in eectively

managing and navigating the intricate landscape of PG in cancercare.

1 Arksey H & O’Malley L. Int J Soc Res Methodol.2005;8:1,19–32.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts184

296

“Self-direction and conformity?” Understanding personal

values of patients with advanced lung cancer in the hospital

setting

Matthias Villalobos-Bollen1; Jan Ole Ludwig1; Mara König1; Laura Unsöld1;

Anja Siegle2; Michael Thomas1

1Thoraxklinik am Universitätsklinikum Heidelberg, Heidelberg, Deutschland

2Duale Hochschule Baden-Württemberg, Stuttgart, Deutschland

Purpose: e aim of this study was to explore personal values of patients

with metastatic lung cancer and their role in the hospital setting.

Methods: Convergent mixed-methods design including collection of

quantitative data of patients (n=66) using the Human Values Scale, group

comparison aer a propensity score matching with the German cohort

of the 9th European Social Survey, semi-structured interviews (n=17)

and qualitative content analysis, integration of data using side-by-side

display. Patients were recruited in the Department of oracic Oncology,

Heidelberg University Hospital.

Results: Quantitative analysis shows that lung cancer patients prioritize

signicantly more the value dimensions of self-transcendence (univer-

salism, benevolence; p=0.03) and openness to change (self-direction,

stimulation; p=0.04). While values of conservation (conformity, tradition,

security; p=0.05) and self-enhancement (power, achievement; p=0.03) are

less important. Besides the armation of self-direction, qualitative data,

contrastingly, shows “conformity” with medical treatment decisions and

the importance of “security”, while revealing the systematic neglect of val-

ues in patient-physician conversations.

Discussion: Our study reveals that values guiding lung cancer patients

dier from the general population, underlining the importance of self-

direction especially at the end of life. Nonetheless, strong conformity

arises in regard to medical treatment decicions. is may show the need

of feeling secure in a complex and uncertain setting, but has also the risk

of over-treatment, particularly when considering the neglect of values

exposed.

Conclusions: Despite guideline recommendations that decision-making

in advanced cancer and especially at the end of life should be based on

patients’ values transfer into every-day practice still lacks the necessary

knowledge and skills. e exposed neglect of values in patient-physician

conversations may jeopardize goal-concordant care and the timely inte-

gration of palliative care.

Disclosure Statement: e authors declare no conict of interest.

362

Distress screening – the OptiScreen training for nurses

Lara Dreismann; Tanja Zimmermann

Medizinische Hochschule Hannover, Klinik für Psychosomatik und

Psychotherapie, Hannover, Deutschland

Background: Psycho-oncological screening is necessary to identify psy-

chologically distressed patients as many patients report increased distress

(approx. 50%) or a psychological disorder (approx. 30%). A special train-

ing on psycho-oncological screening (OptiScreen-training) for nursing

sta was developed and used in a pilot-study. e aim was to reduce bar-

riers in the screening process and to establish an interdisciplinary screen-

ing approach.

Methods: e OptiScreen-training consisted of three modules (psycho-

logical disorders/psychological distress, psychooncology, psychooncolog-

ical screening, communication in the screening process, selfcare) and was

was led by psychotherapists/psychooncologists. e N = 72 nurses who

participated in the 6-hour training evaluated the training with a pre- and

post-questionnaire.

Result: Overall, the results show high satisfaction (62.0-98.6%) with

the design and content of the OptiScreen-training. Personal uncertain-

ties were signicantly reduced by the training (t(63) = -13.322, p < .001,

d = 1.67). Feasibility and overall acceptability from the nursing perspec-

tive were achieved (69.0-94.3%).

Discussion: e OptiScreen-training contributes to minimize barriers on

the part of the treatment team to carry out the screening, inform about

psycho-oncology and to recommend appropriate support services to

patients. Further implementation and evaluation of the training in other

oncology settings is pending.

Conclusion: Trained stu might contribute to identify distressed patients

in a targeted manner in order to provide them with psycho-oncological/

psychotherapeutic care according to their needs.

Disclosure Statement: e authors declare no conict of interest.

390

Eects of Interventions Based on Interpersonal Psychotherapy

on Distress, Depression and Anxiety in Patients with Cancer: A

Systematic Review

Ebba Laing1,2; Jana Heinen1,2; Norbert Schäeler1,2; Stephan Zipfel1,2;

Andreas Stengel1,2,3; Johanna Graf1,2

1Department of Psychosomatic Medicine and Psychotherapy, University

Hospital Tübingen, Section Psychooncology, Tübingen, Deutschland

2Comprehensive Cancer Center Tübingen-Stuttgart, University Hospital

Tübingen, Tübingen, Deutschland

3Charité Center for Internal Medicine and Dermatology, Department for

Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, Corporate

Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin

Institute of Health, Berlin, Deutschland

Background: Cancer patients experience signicant psychosocial distress

associated with cancer diagnosis, treatment, and subsequent life changes.

Stressors include interpersonal diculties such as loneliness, isolation,

thwarted belongingness, communication impediments, and interpersonal

conicts. Interventions are required that address these specic stressors.

Interpersonal psychotherapy (IPT) is a promising concept for the treat-

ment of psychosocial distress in cancer patients because it addresses inter-

actions and role transformations within a patient’s social network. e

aim of this review is to provide an overview of studies of interventions for

patients with cancer based on IPT.

Methods: A systematic review following PRISM guidelines was con-

ducted, including only randomized controlled trials of IPT-based

interventions in cancer patients with assessments of eects on distress,

depression, and anxiety.

Result: Eight studies were included in the review, sampling a total of 390

cancer patients. Seven out of eight studies assessed female breast can-

cer patients only. Two studies described IPT interventions and showed

stronger improvement in depression and anxiety compared to TAU and

equal improvement in depression compared to other psychotherapy inter-

ventions. Seven studies described remote interpersonal counselling (IPC).

One study found the intervention to be superior to control condition

regarding depression, and one study found the intervention to be superior

to attention control, but not active control conditions. No study found the

intervention to be superior to control conditions regarding distress.

Discussion: ere are few randomized control trials of IPT for cancer

patients. Results regarding depression and anxiety are promising for

in-person IPT, but mixed for remote IPC.

Conclusion: Concepts of IPT can be adapted to oncology settings. To

inform decisions on implementation of IPT interventions, research with

more diverse groups of cancer patients is called for.

PROSPERO ID. CRD42023410687

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 185

409

Online or face-to-face? The video consultation in oncology

Friederike Kendel1; Dorothee Speiser2; Ahmed Magheli3; Markus Feufel4

1Charité - Universitätsmedizin Berlin, Geschlechterforschung in der Medizin,

Berlin, Deutschland

2Charité - Universitätsmedizin Berlin, Zentrum Familiärer Brust- und

Eierstockkrebs, Berlin, Deutschland

3Vivantes, Klinikum Am Urban, Urologische Klinik, Berlin, Deutschland

4Technische Universität Berlin, Fachgebiet Arbeitswissenschaft, Berlin,

Deutschland

Background: ere is little known about how doctor-patient interaction

changes in the video consultation. erefore, the aim of the OVID study

was to describe quantitative and qualitative dierences between video

consultation (VC) and face-to-face consultation (FC) with regard to phy-

sician-patient interaction and to identify barriers to the use of VS.

Methods: We conducted a cross-sectional quasi-experimental study using

a mixed-methods design. e sample consisted of N = 73 cancer patients

and their physicians. We recorded and systematically compared VC and

FC regarding verbal and nonverbal aspects. In addition, we conducted

semi-structured interviews with 10 patients and 10 physicians.

Results: In the VC physicians had a higher proportion of speech and

asked fewer open questions than in the FC. e structure of the conver-

sation also diered. In the interviews, the most important advantages of

the VC mentioned by patients were the reduced travel, infection protec-

tion, and the familiar home environment. However, disadvantages such

as technical and organizational barriers were also mentioned, and there

were concerns that the quality of doctor-patient interaction might suer.

On the physicians’ side, advantages were mainly seen in infection control,

spatial independence, time eciency and improved health care in rural

areas. Both physicians and patients were condent that a positive physi-

cian-patient interaction could also be established in the VC.

Discussion and Conclusion: Challenging conversations are also possi-

ble in the VC. However, barriers must be removed to increase acceptance

and use of the VC. Solutions to technical and organizational diculties

are needed. In addition, doctor-patient communication in the VS also

requires new behavioural routines.

Disclosure Statement: e authors declare no conict of interest.

456

LOGOS - A hybrid intervention study of meaning-centered

psychotherapy for adult cancer survivors in aftercare

Annekathrin Sender; Lisa Schiebeck; Antje Lehmann-Laue;

Anja Mehnert-Theuerkauf

Universität Leipzig/Universitätsklinikum Leipzig, Medizinische Fakultät,

Abteilung für Medizinische Psychologie und Medizinische Soziologie, Leipzig,

Deutschland

Background: Living with a history of cancer is oen associated with

physical and psychosocial short and long-term eects. Existential distress

in coping with the disease is experienced by many cancer survivors and

remains an important factor even aer the end of treatment. Initial stud-

ies of meaning-centered psychotherapy (MCP) based on Breitbart (2017)

have shown high clinical ecacy in dealing with these existential issues.

Aim of the pilot study LOGOS is to adapt the MCP for cancer survivors

with a curative prognosis for the rst time in Germany.

Methods: Adult cancer survivors (n=36) are assigned to a group setting or

individual sessions (face-to-face or hybrid) and participate in eight man-

ualized MCP sessions over 16 weeks. Feasibility, satisfaction and initial

trends will be assessed by standardised validated questionnaires and qual-

itative interviews.

Result: First results and trends of the three measurement points (t0-base-

line; t1 aer 4 sessions, t2 aer 16 weeks) as well as specics of the hybrid

approach will be reported.

Discussion: MCP as a potentially highly relevant intervention for the

quality of life of cancer survivors can improve psycho-oncological sup-

port in aercare. With the completion of LOGOS, a proven manualized

group and hybrid individual MCP program will be available for cancer

survivors, providing insights into feasibility, acceptance, and satisfaction

with MCP in German speaking countries.

Conclusion: MCP for cancer survivors can enhance sense of purpose,

spiritual well-being and quality of life, and reduce anxiety and depressive

symptoms. e brief, structured and manualized MCP, which can be car-

ried out in hybrid setting and therefore independent of location, can pro-

vide psycho-oncologists an additional therapeutic tool.

Indication of source:

1 Breitbart, W. (Hrsg.). (2017). Meaning-centered psychotherapy in the cancer

setting: Finding meaning and hope in the face of suering. Oxford University

Press.

Disclosure Statement: e authors declare no conict of interest.

467

Implementation of a best practice guideline on

psychooncological screening at a comprehensive cancer

center – evaluation of the inuence of best practice on patient

care and patient-reported outcomes

Rebecca Bremen; Susanne Isfort; Jens Panse; Tim Henrik Brümmendorf;

A.Petermann-Meyer

Uniklinik RWTH Aachen, Klinik für Hämatologie, Onkologie, Hämostaseologie

und Stammzelltransplantation, Centrum für Integrierte Onkologie Aachen Bonn

Cologne Düsseldorf (CIO ABCD), Aachen, Deutschland, Aachen, Deutschland

Background: Comprehensive care for cancer patients (pts) should focus

on pts’ individual needs. us, all pts are to be screened for distress in

order to assure a timely identication of psychosocial burden and to initi-

ate adequate intervention. German experts consented a best practice (bp)

which provides guidance on psychoncological screening in comprehen-

sive cancer centers (CCCs) (Stengel et al., 2023). However, to date there

is a) no overview of the current screening processes, b) no comprehen-

sive implementation of the bp, c) a lack of evidence on the eect of bp

on screening rates and patient outcomes and d) a lack of information on

required resources for adapting bp. e oPoS study aims at systematical

implementation and evaluation of the bp at twelve wards of a German

center for integrated oncology (CIO).

Methods: Monocentric pilot study (07/23-06/24) with a mixed-method

approach in four phases: (1) state analysis, (2) bp implementation, (3)

patient survey and (4) evaluation.

Result: e study protocol will be provided in detail. e results of the

state analysis will be available at the congress and presented.

Discussion: e study presents a comprehensive and systematic approach

to the implementation and evaluation of bp guidelines at a CCC. e

pilot study uses a thorough design to translate guidelines into practice

and thereby generating valuable scientic and practical insights on a) the

current screening processes b) how to implement bp, c) the eects and d)

the resources required.

Conclusion: e study addresses a key aspect in comprehensive cancer

care. e study’s results will enable a more informed translation of best

practice guidelines on distress screening into clinical practice.

Indication of source:

1 Stengel, A., Dinkel, A., Karger, A. et al. Best Practice: psychoonkologisches

Screening an Comprehensive Cancer Centers. Forum 36, 278–283 (2021).

Disclosure Statement: e authors declare no conict of interest. e study is an

investigator-initiated study funded by the Faculty of Medicine RWTH Aachen.

DRKS-ID DRKS00032286.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts186

486

Post-traumatic Growth in Breast Cancer Patients in

Association with Resilience, Self-ecacy, Optimism and

Positive Emotions - A longitudinal Study

Ute Berndt1; Katharina Schäfer2; Bernd Leplow3; Andreas Wienke4;

Christoph Thomssen5

1Department of Gynecology, University Hospital Martin-Luther-University

Halle-Wittenberg, Halle (Saale), Deutschland

2Department of Psychology, Martin- Luther- University Halle-Wittenberg, Halle

(Saale), Deutschland

3Department of Psychology, Martin- Luther- University Halle-Wittenberg, Halle

(Saale), Deutschland

4Department of Medical Epidemiology, Biostatistics, and Informatics,

Martin-Luther-University Halle-Wittenberg, Halle (Saale), Deutschland

5Department of Gynecology, University Hospital Martin-Luther-University

Halle-Wittenberg, Halle (Saale), Deutschland

Background: Breast cancer is a potentially traumatic experience oen

accompanied by emotional distress, anxiety and depression. However,

patients also report positive changes in association with their coping pro-

cess, known as post-traumatic growth (PTG).

Methods: is study aimed to assess PTG three times: aer diagnosis

(t1), six-months later (t2) and four to eight years aer diagnosis (t3).

Furthermore, the impact of personality traits (resilience, optimism,

self-ecacy) and positive emotions on PTG was investigated. One hun-

dred and thirteen women recently diagnosed with stage I to III breast

cancer were included in the study. ey completed self-report measures of

PTG, personality traits and positive emotions at three times. Additionally,

sociodemographic characteristics, emotional distress, anxiety and depres-

sion were measured.

Result: Sixty-two patients provided complete data. A repeated meas-

ures ANOVA revealed a signicant increase of PTG-scores from t1 to t2

(MDi=-5.7, p=.004, CI [-9.99; -1.51]) and t1 to t3 (MDi=-5.4, p=.01, CI

[-9.83, -0.91]) but not between t2 to t3 (p=1.0). However, the individual

PTG proles over time were heterogeneous. Moreover, a multiple linear

regression was performed to evaluate inuencing factors on PTG. Positive

emotions are predictors on PTG at t2 (β=.526, p=.003, CI [0.187, 0.864])

and t3 (β=.611; p<.001, CI [0.296; 0.926]. Resilience was inversely associ-

ated with PTG on t2 (β=-.606, p=.015, 95% CI [-1.09; -0.124]).

Discussion/Conclusion: PTG was mainly present in the rst six months

aer diagnosis. Positive emotions enhance PTG and should be supported

in psycho-oncological practice. Higher levels of resilience may lead to

a less traumatic experience, which is a predisposition for developing

ofPTG.

Disclosure Statement: e authors declare no conict of interest.

491

Distress and support needs among cancer patients and their

family caregivers

Felicitas Lingenhöl; Dirk Arnold; Georgia Schilling

Asklepios Tumorzentrum Hamburg, Standort Altona, Hamburg, Deutschland

Purpose: e psychosocial consequences of cancer for patients are inten-

sively studied. However, little is known about the psychosocial distress

of their family caregivers. erefore, this study assessed the distress

levels of 100 cancer patients and their family caregivers in comparison.

Furthermore, the dierences regarding distress between patients with var-

ious tumor entities and dierent disease settings were investigated.

Methods: e assessment was done once by means of the NCCN dis-

tress thermometer and its 36 items issue list in 100 cancer patients and

their family caregivers in dierent outpatient clinics at the Asklepios

Tumorzentrum Hamburg. All tumor entities were included.

Result: e median overall burden of cancer patients was assessed with

“6” on the scale of 0-10, whereas family caregivers scored “5”. 32% of the

patients expressed the wish to get support by a psycho-oncologist, as 25%

of the family caregivers did. 34% of the family caregivers indicated an

interest in having special consultation hour. Patients were more likely to

suer from physical problems such as fatigue or mobility, while family

caregivers reported more psychological burdens such as worries and fears.

e highest distress levels were reported by family caregivers of patients

with lung cancer (7) or with cancer recurrence (6).

Discussion: Some studies report that the family caregivers of cancer

patients suer even more from distress, than the patients themselves. In

contrast, this work found that the overall burden was about the same. But

our study gives more detailed insights in the issues patients and family

caregivers suer from.

Conclusion: In summary, in this work the distress of family caregivers of

patients with cancer is about the same than that of the patients themselves,

although he latter suer even more from fears and psychosocial burdens.

is is reected by the high proportion of family caregivers wishing spe-

cialized interventions. erefore, this work clearly shows the need for

specialized programs, like support groups or special consultation hours.

Disclosure Statement: e authors declare no conict of interest.

518

Screening psychosocial care needs in patients with glioma by

physician-led conversation versus questionnaires: a cluster

randomized controlled trial

Mirjam Renovanz1,2; Robert Kuchen3; Melina Hippler1; Martin Voss4;

Joachim Steinbach4; Michael Ronellentsch4; Almuth F. Keßler5;

Martin Misch6; Julia Sophie Onken6; Marion Rapp7; Lorenz Doerner1;

David Rieger1; Minou Nadji-Ohl8; Carolin Weiß Lucas9; Jan Coburger10;

Marcus Mehlitz11; Jürgen Meixensberger12; Michael Karl Fehrenbach12;

Naureen Keric13; Jens Wehinger14; Friederike Schmidt-Graf15; Jens Gempt16;

Marcos Tatagiba2; Ghazaleh Tabatabai1; Melanie Schranz3,17;

Susanne Singer3,17

1Neurologische Universitätsklinik | Universitätsklinikum Tübingen, Abteilung

Neurologie mit interdisziplinärem Schwerpunkt Neuroonkologie, Hertie Institut

für klinische Hirnforschung, Tübingen, Deutschland

2Universitätsklinikum Tübingen, Klinik für Neurochirurgie, Tübingen,

Deutschland

3Institut für Medizinische Informatik, Biometrie und Epidemiologie,

Universitätsmedizin Mainz, Mainz, Deutschland

4Dr. Senckenbergisches Institut für Neuroonkologie, Frankfurt am Main,

Deutschland

5Neurochirurgie - Uniklinikum Würzburg, Würzburg, Deutschland

6Charité - Universitätsmedizin Berlin Klinik und Poliklinik für Neurochirurgie,

Berlin, Deutschland

7UKD - Klinik für Neurochirurgie, Düsseldorf, Deutschland

8Neurochirurgische Klinik | Klinikum Stuttgart, Stuttgart, Deutschland

9Uniklinik Köln, Köln, Deutschland

10Universitätsklinikum Ulm Klinik für Neurochirurgie, Ulm, Deutschland

11Krankenhaus der Barmherzigen Brüder Trier, Neurochirurgie, Trier,

Deutschland

12Klinik und Poliklinik für Neurochirurgie Universitätsklinikum Leipzig, Leipzig,

Deutschland

13Neurochirurgische Klinik und Poliklinik, Mainz, Deutschland

14Klinikum Ludwigsburg Klinik für Neurologie, Ludwigsburg, Deutschland

15Klinikum rechts der Isar der TU München - Klinik und Poliklinik für Neurologie,

München, Deutschland

16Neurochirurgische Klinik und Poliklinik am Klinikum rechts der Isar, München,

Deutschland

17Universitäres Centrum für Tumorerkrankungen, Universtitätsmedizin Mainz,

Mainz, Deutschland

Background: Patients with high-grade gliomas (HGG) suer from

increased distress. However, due to neurological/neurocognitive decits,

assessment is challenging. We evaluated whether psychosocial screening

can be improved by face-to-face ascertainment during doctor- patient-

consultation compared to using a questionnaire.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 187

Methods: In a two-arm multicenter cluster-randomized study with 13

centers we compared screening of HGG patients’ psychosocial distress in

doctor-patient-conversation (intervention group, IG) to assessment via

validated questionnaire (control group, CG). Patients with a glioblastoma

or a diuse glioma CNS WHO-grade 3 or 4 were included. e main out-

come was the proportion of HGG patients with increased psychosocial

distress who receive psychosocial care (PC).

Result: In total, 763 patients were enrolled, 506 patients were included

in the nal analysis. Mean age was 52 years (range 19-86), 286 were male

(56.5%), the majority diagnosed with a glioblastoma (294/506, 58.1%).

According to the emotional functioning scale (EORTC QLQ-C30),

302/506 patients (59.9%) showed relevant psychosocial burden [1]. e

frequency of patients reporting having received outpatient PC was simi-

lar in both groups (IG 60/168; 38% vs. CG 50/134; 41%, odds-ratio (OR)

0.85, p=0.53). In the IG, the proportion of burdened patients forwarded

to PC according to doctors’ report was higher (IG 46/168; 28.4% vs. CG

30/134; 23.6%, OR 1.24, p=0.67) as well as use of PC during inpatient care

according to medical records (IG 50/168; 29.8% vs. CG 29/134; 21.6%,

OR 1.35, p=0.43).

Discussion: Screening for distress in HGG patients via face-to-face con-

versation was comparable to screening via questionnaires in terms of

self-reported use of psychosocial services later on. Furthermore, it led to

increased doctor-reported and in medical records documented referral to

such services.

Conclusion: Our results show that HGG patients might benet from a

facilitated screening integrated in a patient-doctor consultation.

Reference:

1. Giesinger JM et al. J Clin Epidemiol. 2020, PMID: 31639445.

Disclosure Statement: e authors declare that there are conicts of interest.

econicts were submitted to the congress organizer KUKM GmbH and KUKM

can disclose them if needed.

613

Experiencing pancreatic cancer from a patient‘s perspective -

results of a grounded theory study on people with pancreatic

adenocarcinoma from Germany

Patrick Ristau1,2; Claudia Oetting-Roß3; Andreas Büscher1,4

1Witten/Herdecke University, Faculty of Health, School of Nursing Science,

Witten, Deutschland

2University of Lübeck, Institute for Social Medicine and Epidemiology, Nursing

Research Unit, Lübeck, Deutschland

3FH Münster, University of Applied Sciences, Münster School of Health, Münster,

Deutschland

4Osnabrück University of Applied Sciences, Faculty of Business Management

and Social Sciences, Osnabrück, Deutschland

Background: People with pancreatic cancer face many challenges, and

health status changes within a short period of time. To date, no com-

prehensive or cancer-specic trajectory model integrates the patient’s

perspective.

Methods: Following grounded theory methodology, data collection and

analysis were iterative. A total of 26 problem-centered interviews were

conducted with pancreatic cancer patients of all stages from Germany.

e transcripts were rst openly and later axially and nally selectively

coded.

Results: Being diagnosed with pancreatic cancer is a life-changing event.

Patients make a clear distinction between the pre- and post-diagnosis

period. Immediately aer diagnosis, they focus on mere survival, react to

short-term challenges, and search for answers to arising questions. is

initial phase is followed by a circular phase of living on with pancreatic

cancer: Patients adapt to the longer-term consequences of pancreatic can-

cer and its associated challenges. Meanwhile, they experience their lives

repeatedly threatened by follow-up examinations, fearing recurrence or

progression in this context.

Discussion: Within this study, some pancreatic cancer-specic peculiar-

ities in the disease experience could be elaborated, which seem to distin-

guish pancreatic cancer from other cancer entities. ese ndings enabled

the development of a pancreatic cancer-specic trajectory model based on

patients’ experiences, which considers all stages of the disease.

Conclusion: Experiencing pancreatic cancer diers from living with

other cancers. Particularly noteworthy is the repeated perceived threat to

life in connection with check-ups. Understanding the patient’s perspec-

tive on their disease enables health professionals to better address patients’

needs, concerns, and fears.

Disclosure Statement: e authors declare no conict of interest.

630

Guideline-based, long-term care for children and adolescents

ve years after the end of cancer treatment (AELKI): Feasibility

and Acceptance of Psychosocial Aftercare

Lisa Hohls1; Hannah Schmidt1; Katja Baust2; Hera Becker1; Nicole Griech2;

Annecke Röttger1; Katharina Tetzner2; Anja Borgmann-Staudt3; Jörg

Faber4; Michael Frühwald5; Gabriele Escherich6; Gabriele Calaminus2;

Ingo Menrath1; Thorsten Langer1

1Universitätsklinikum Schleswig-Holstein, Lübeck, Deutschland

2Universitätsklinikum Bonn, Bonn, Deutschland

3Charité-Universitätsmedizin Berlin, Berlin, Deutschland

4Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz,

Deutschland

5Universitätsklinikum Augsburg, Augsburg, Deutschland

6Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland

Background: In Germany, approximately 2100 children and adolescents

are diagnosed with cancer every year. Despite good long-term survival

rates, many patients are aected by late eects of the oncological disease

and therapy. Although long-term follow-up care as secondary prevention

is required, necessary structures have not yet been established nationwide

in the regular care. Especially psychosocial care is oen lacking. e aim of

this study is to evaluate a risk-adapted, multidisciplinary, guideline-based

long-term follow-up care with a main focus on psychosocial aercare.

Methods: In a cluster-randomized prospective multicenter study, opti-

mized aercare will be compared with standard treatment as usual (TAU)

in ten study centers in Germany. Five intervention clinics (each will

recruit 160 patients who have completed at least ve years of follow-up

care) will provide guideline-based interdisciplinary medical follow-up

and appointments up to four psychosocial consultations by a psychologist

or social worker, depending on individual needs. In an initial exploratory

analysis, the documentation of the psychosocial sessions is evaluated with

regards to potential factors inuencing the feasibility and acceptance of

the optimized treatment.

Result: Preliminary analyses demonstrate various challenges in imple-

menting risk-adapted, guideline-based, multidisciplinary aercare and

transition in clinical settings. With few exceptions, patients are generally

accompanied by their parents.

Discussion: Implications for future structuring and a needs-based, multi-

disciplinary adaptation of psychosocial services in long-term follow-up

care for families formerly aected by cancer are discussed.

Conclusion: Initial experience shows that both patients and health care

providers will benet from structured multidisciplinary care.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts188

659

How do health care providers manage acutely suicidal cancer

patients with limited life expectancy?

Till Johannes Bugaj1; Thomas Fehn2; Christina Sauer1;

Corinna Seliger-Behme2

1Department for General Internal Medicine and Psychosomatics, University

Hospital Heidelberg & National Center for Tumor Diseases (NCT), University

Hospital Heidelberg, Heidelberg, Deutschland

2Department of Neurology, University Hospital Heidelberg, Heidelberg,

Deutschland

Background: People suering from advanced cancer sometimes consider

suicide, e.g. because they fear dependence on others. Some health care

providers (HCP) consider it morally dicult to restrict the autonomy of

these patients. Although it should be beyond doubt that attention should

be paid to possible suicidality in cancer patients, there is reason to believe

that the well-described treatment pathway for acutely suicidal patients

(accommodation, even against the patient’s will) is sometimes disregarded

in the case of these patients. e aim of this study is to investigate treat-

ment pathways commonly used by various HCP to care for suicidal cancer

patients.

Methods: e study surveyed primary care physicians, practicing

oncologists, psychiatrists from hospitals with psychiatric emergency

departments, and psycho-oncologists working in Baden-Württemberg,

Germany. erefore, the authors constructed a questionnaire dealing with

suicidality in cancer patients utilizing quantitative and qualitative items.

Furthermore, case vignettes were generated to evaluate which treatment

pathways the HCP would take in a ctional patient case. Potential partic-

ipants were identied through a register search and then invited via email

to participate anonymously. With this email they also received access to

the online questionnaire (SoSci Survey GmbH). Data were downloaded

for analysis.

Results: Data collection was completed in August 2023. e following

response rates were recorded: Primary care physicians: 28/2.569 (1%),

oncologists 1/53 (1.9%), psychiatrists 1/87 (1.1%), psycho-oncologists

23/80 (28.8%). Data analysis will be completed by the time of the congress.

Discussion: A rst apparent result is the low study participation. However,

those who participated reported very dierentiated conicts and experi-

ences regarding this topic.

Conclusion: An initial review of the response rates and results of this

study suggests that suicidality in cancer patients is of varying importance

to dierent HCP.

Disclosure Statement: e authors declare no conict of interest.

667

Cancer counseling app for patients and their relatives.

Presenting the prototype developed through a series of

scientic and evidence-based steps

Natalie Röderer1; Tanja Bratan2; Mahsa Fischer3; Sebastian Kuhn4;

Hartmut Kopf 5; Claudia Schlüfter2; Shayan Momeni3; Alexander Wünsch1,6

1Universitätsklinikum Freiburg, Klinik für Psychosomatische Medizin und

Psychotherapie, Freiburg, Deutschland

2Fraunhofer-Institut für System- und Innovationsforschung ISI, Geschäftsfeld

Innovationen im Gesundheitssystem, Karlsruhe, Deutschland

3Hochschule Heilbronn, Fakultät Wirtschaft und Verkehr, Abteilung

Wirtschaftsinformatik, Heilbronn, Deutschland

4Philipps-Universität Marburg, Institut für Digitale Medizin, Marburg,

Deutschland

5Duale Hochschule Baden-Württemberg Villingen-Schwenningen, Studiengang

Sozialwirtschaft, Villingen-Schwenningen, Deutschland

6Inselspital, Universitätsspital Bern, Universitätsklinik für Medizinische

Onkologie, Bern, Schweiz

Background: Digital support services are being increasingly used in

psycho-oncology. Despite the growing availability of various apps, the

important impact factor of the relationship between patients and coun-

selors is oen neglected. Hence, the goal is to develop a smartphone

app for outpatients and their relatives that provides easy access for sup-

port and has a focus on the patient-counselor relationship. Here, we will

present the prototype, which has been developed through scientic and

evidence-based steps.

Methods: In a rst step, qualitative interviews on requirements for an

app have been conducted with patients, relatives and counselors. ese

interviews were transcribed, categorized and analyzed according to qual-

itative content analysis [1]. In a second step, an interdisciplinary consen-

sus of psycho-oncologists, health scientists, IT experts and a digital health

expert discussed the issue using an ethics canvas. Based on these results,

fundamental app content and functions were dened and developed. e

prototype was evaluated involving patients, relatives, and counselors.

Result: We derived the following three contents and functions of the app

from the development steps: provision of sound information, oer of psy-

chosocial interventions and - of particular importance - easy access to

counseling. A prototype has been developed.

Discussion: e app development is based on scientic results and incor-

porates input from patients, relatives and advisors. It has a great potential

e.g. for patients in rural areas, dealing with multiple burdens or language

barriers.

Conclusion: An app oers a good opportunity to complement psycho-on-

cological counseling in a sustainable way. We see the further development

of the app in integrating personal counseling in a blended counseling or

stepped care approach.

Indication of source:

[1] Kuckartz, U., & Rädiker, S. (2022). Qualitative Inhaltsanalyse: Methoden,

Praxis, Computerunterstützung (5. Au). Beltz Juventa.

Disclosure Statement: e authors declare no conict of interest.

668

Male counselees at the Hereditary Breast and Ovarian Cancer

Centre Berlin - characteristics and possible psychological

impact

Charlotte Koch1; Nanette Kalmbach1; Nora Amirpour-Mehrhof1; Jenny

Katharina Wagner1; Nicole Zilski1; Jens-Uwe Blohmer1; Dorothee Speiser1;

Ute Goerling2

1Charité – Universitätsmedizin Berlin, Zentrum Familiärer Brust- und

Eierstockkrebs, Klinik für Gynäkologie mit Brustzentrum, Berlin, Deutschland

2Charité Comprehensive Cancer Center, Berlin, Deutschland

Background: Hereditary breast and ovarian cancer syndrome mainly

aects women. However, it is crucial to recognize that men can also

develop genetic breast and prostate cancer, and carry pathogenic germline

variants such as those found in the BRCA1/2 gene. Previous studies have

shown that there are signicant gender dierences in the way genetic

counseling and family cancer risks are handled [1]. us, our objective

is to investigate the male population seeking genetic counseling for these

concerns.

Methods: We retrospectively collected data on men who presented for

genetic counseling and testing at the Hereditary Breast and Ovarian

Cancer Centre at Charité Berlin (HBOC) from 2016-2023. Demographic

data, family history of cancer and the result of the genetic testing were

evaluated. In addition, the men were sent a questionnaire that examined

motivation for the genetic test, psychological impact (using the MICRA

questionnaire), health awareness and coping mechanisms related to the

process.

Result: Within the specied time period, a total of N=324 men received

genetic testing at the HBOC-Centre Charité. Average age at testing was

52 years. N= 51 (16.2%) had cancer at the time of testing, of which N=35

(68.6%) had male breast cancer. A pathogenic variant was detected in

N=134 men (41.4%). e BRCA1 gene demonstrated the highest prev-

alence, with N=71 (21.9%) cases, followed by the BRCA2 gene (12.7%).

e results of the questionnaire on the psychological impact of the genetic

tests are still pending.

Discussion: Final results from our study will be compared to former stud-

ies and presented at the conference.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 189

Conclusion: In order to provide a gender-specic counseling service, it

is important to involve male family members and to be aware of possible

gender dierences in dealing with genetic testing and its results.

Indication of source:

1. Dwyer, A.A., et al., Coping response and family communication of cancer risk

in men harboring a BRCA mutation: A mixed methods study. Psychooncology,

2022. 31(3): p. 486–495.

Disclosure Statement: e authors declare no conict of interest.

687

Implementation of a psycho-oncological screening according

to the new DKG indicator: An interdisciplinary approach at the

Oncology Centre CIO Cologne

Daniela Breitschuh1; Johannes Bösche1; Barbara Strohbücker2;

Steen Krebs3; Scarlett Berressem3; Vera Schiewer1; Christian Albus4;

Christiana Muth1

1Department I of Internal Medicine, University Hospital of Cologne, Köln,

Deutschland

2Nursing development, University Hospital of Cologne, Köln, Deutschland

3CIO Cologne, University Hospital Cologne, Center for Integrated Oncology

Aachen Bonn Cologne Duesseldorf (CIO ABCD), Köln, Deutschland

4Department of Psychosomatics and Psychotherapy, University Hospital of

Cologne, Köln, Deutschland

Background: e introduction of a new certication-relevant indicator

for psycho-oncology (PO) screening of ≥65% requires structural change

processes in everyday PO care. An interdisciplinary, structural solution

approach for the implementation of a profound PO distress screening

(PDS) is shown.

Methods: e change process is based on an interdisciplinary quality

management of psycho-oncologists, nursing teams and experts, medical

and administrative sta. e cooperation is characterized by a partici-

patory process involving all hierarchy levels. A hybrid PDS (analog and

digital) system was developed using the distress thermometer. e imple-

mentation of the PDS in the central hospital information system enables

a continuous quantitative evaluation. A qualitative survey focusses on

employee satisfaction.

Result: Central process elements are consistently practiced interdiscipli-

nary as well as assumption of responsibility by nurses for the PDS and for

the assignment to the PO. Initial qualitative results show an increase in the

nurses’ experience of competence. In parallel, PO ratios increased from

5%-40% to 45%-80% within the rst follow-up quarter.

Discussion: e interdisciplinary process performance allows a break-

through in the improvement of the PO indicator. Enabling factors are

participatory process design involving all hierarchical levels and the

availability of oncology nursing experts, who act as change agents dur-

ing implementation. Inhibiting factors are dierent access routes from

the oncological treatment to PO care and incompatible documentation

systems. At the same time, the sharp increase in the number of PDS high-

lights the actual need for care, which is not covered by the psycho-onco-

logical sta under the given budgetary restrictions.

Conclusion: Meeting the new DKG requirements is made possible by

consistent interdisciplinary and participatory approach, as well as a bind-

ing assumption of responsibility with sucient resources.

Disclosure Statement: e authors declare no conict of interest.

692

The association between Health-Related Quality of Life

(HRQoL) and psychosocial burden of cancer patients during

psycho-oncological treatment – Results of a longitudinal

quantitative study

Lena Hagedorn1; Holger Schulz2; Katharina Scheold2

1Palliative Care Unit, Department of Oncology, Hematology and BMT, University

Medical Center Hamburg-Eppendorf, Hamburg, Deutschland

2Department of Medical Psychology, University Medical Center Hamburg-

Eppendorf, Hamburg, Deutschland

Purpose: A majority of cancer patients show high rates of psychological

burden and lower HRQoL. erefore, early diagnosis of psychosocial bur-

den and HRQoL in cancer patients is indicated. e aim of this study was

to assess the prognostic validity of the EORTC QLQ C30 questionnaire

to examine the association between HRQoL and psychosocial burden in

cancer patients undergoing psycho-oncological treatment.

Methods: A quantitative questionnaire survey was conducted among

cancer patients from the outpatient clinic for psycho-oncology at the

University Medical Center Hamburg-Eppendorf. Data was collected at

baseline (start of treatment; n=2489) and aer 6 months (n=677) of psy-

cho-oncology treatment. We used the functional scales (physical, role,

emotional, cognitive, social) and the global health status of the EORTC

QLQ C30 and related it to psychosocial burden (depression, anxiety,

distress) at both time points. As a primary outcome we analysed the

association between the level of functioning and global QoL at baseline

on depression aer 6 months. Data was analysed using multiple linear

regressions.

Results: Higher HRQoL at the beginning of psycho-oncological treatment

was associated with lower levels of depression at 6 months. e model

shows that HRQoL (at baseline) accounts for 28% (adjusted R2=.283) of

the level of depression at 6 months. In a further analysis only depression

at baseline was initially entered into the model as a predictor. Aerwards,

the HRQoL scales were also included as predictors. In summary, HRQoL

accounted for an additional 3% (R2=.026) of the variance in depression

at 6 months. Signicant predictors were physical functioning, cognitive

functioning, emotional functioning and global QoL.

Discussion: Aer adjustment for baseline depression, the results show a

weak association of HRQoL with psychosocial burden in the course of

psycho-oncology treatment.

Conclusion: Early assessment of psychosocial burden should be an

important measure to assess the long-term development of psychological

burden and the individual indication for treatment.

Disclosure Statement: e authors declare no conict of interest.

720

Piloting „Kurzzeitintervention Progredienzangst” (KIPA) – a

program to reduce Fear of Progression (FoP) in families with

a child with cancer

Jessy Herrmann1; Anja Santel1; Laura Schupp2; Florian Schepper2

1Elternhilfe für krebskranke Kinder Leipzig e.V., Leipzig, Deutschland

2Selbstständige Abteilung für Pädiatrische Onkologie, Hämatologie und

Hämostaseologie um Universitätsklinikum Leipzig, Leipzig, Deutschland

Background: For pediatric oncology patients and their parents in particu-

lar FoP is a long-lasting psychosocial burden. While promising programs

for adult patients exist, the specic needs in pediatric settings have not yet

been addressed.

Methods: We recruited twenty-two families with a child with cancer (age:

0-17 years) in acute treatment or follow-up care and elevated FoP-levels

of at least one family member. Either one parent (n=14), both parents

(n=2), or a parent-child dyad (n=6) could participate. Families were ran-

domly assigned to a waitlist control group with usual care (n=10) or eight

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts190

sessions KIPA (n=12) consisting of psychoeducation, anxiety exposure,

and resource activation. ey completed the FoP-Q-SF/P or C (12-item,

ve point Likert scale) at (pre-)baseline (P/BL), aer intervention (T1)

and four months later (T2). We calculated Wilcoxon-Mann-Whitney-

Tests and Hedge’s g eect sizes.

Result: When comparing KIPA with usual care, there is a signicant

decrease of parental FoP (W=78, p=.002) with large eect size (g=0.964)

and a non-signicant decrease of child’s FoP (W=12, p=.313) with still a

medium eect (g=0.513). When analyzing all groups, parents (MFoP=36,05)

are more burdened with FoP than children (MFOP=27,5) and only parental

FoP lowers signicantly from BL to T1 (W=246, p<.001; g=1.057) and

remains stable until T2 (W=108, p=.819; g=-0.012).

Discussion: ese preliminary results suggest that KIPA can signicantly

reduce parental FoP. For children, this treatment approach also seems

promising. However, a signicant limitation of our data is the small sam-

ple size, particularly for children. eir poor participation may reect

their lower FoP burden.

Conclusion: KIPA represents an initial approach to treating elevated FoP

in pediatric oncology. Further testing of the ecacy of KIPA on larger

samples and catamnestic surveys to analyze long-term eects are needed.

Disclosure Statement: e authors declare no conict of interest.

753

Adapting Interpersonal Therapy for Psycho-oncological Care:

Addressing Distress and Depression in Cancer Patients

Rita Acebo

Uniklinik Tübingen, Tübingen, Deutschland

Background: A cancer diagnosis triggers signicant life changes and

an increased need for social support, oen accompanied by distress and

depressive symptoms in patients. Interpersonal erapy (IPT) is eective

in addressing these issues, making it suitable for psycho-oncological care.

is abstract discusses the development of an adapted IPT model for can-

cer patients with distress or depressive symptoms. e adaptation includes

classic IPT elements (grief, role transitions, disputes, decits) and inte-

grates mindfulness, cancer-related psychoeducation, self-care, and group

support.

Methods: We tailored a 12-week group psychotherapeutic program based

on strategies proven eective for cancer patients with distress or depres-

sion. We conducted a comprehensive needs assessment, adapting IPT

elements to address cancer-related role transitions, social dynamics, and

interpersonal diculties. Participants (diagnosed with cancer and at least

mild depressive symptoms) undergo pre-therapy psychological diagnos-

tics. We engage patients in dening personal therapy goals. Hybrid partic-

ipation options are oered, and psychosocial crisis care is available. Aer

completing the program, we assess outcomes, including distress reduc-

tion, improved quality of life, and reduced depressive symptoms.

Result: While the study is ongoing, our adapted IPT approach aims to

eectively address cancer patients’ multifaceted needs. Combining clas-

sic IPT with mindfulness, psychoeducation, and group support, we

anticipate reducing depressive symptoms and enhancing well-being and

relationships.

Discussion: We will discuss the benets and challenges of this approach,

considering preliminary data.

Conclusion: Addressing depression is crucial for cancer patients’ men-

tal health and overall well-being. Evidence-based IPT adaptation may

enhance psycho-oncological care. As data collection continues, we hope

to provide insights into this innovative approach’s eectiveness.

Disclosure Statement: e authors declare no conict of interest.

796

Funding of outpatient cancer counseling centers by the health

insurance funds - Utilization and initial assessments by the

counseling centers and providers (the KEVA-study)

Jochen Ernst; Svenja Heyne; Anja Mehnert-Theuerkauf;

Charlotte Gmeiner; Maria Mahlberg; Susanne Kuhnt

Department of Medical Psychology and Medical Sociology, University Medical

Center Leipzig, Leipzig, Deutschland

Submission Type: poster presentation.

Purpose: Since 2020/21, the health insurance funds contribute to the

costs of outpatient psychosocial cancer counseling centers (Ambulante

Krebsberatungsstellen - KBS). Currently, there is no reliable data on the

implementation of this funding option. e research questions of our

evaluation study are therefore: (1) how is outpatient cancer counseling

in Germany positioned in terms of structural aspects, oers and quality

criteria (compared to study results from 2015/2016), (2) how do providers

and KBS evaluate the funding opportunity and what are the reasons or

barriers to non-use?

Methods: We conduct (1) a nationwide quantitative structural survey

with all KBS. e focus is on the structure of provision, e.g., oers, sta-

ing and nancing structure. To assess the use and implementation of the

funding oer, (2) qualitative interviews are conducted with selected KBS

and providers (quota sample, N=30 KBS resp. 11 providers).

Results: For the quantitative survey, we contacted N=174 KBS. Out of

these, N=100 have returned a complete questionnaire to date (response

rate=57.5%). e survey and data analysis will be completed by early 2024.

At the DKK we will present the results of the quantitative survey.

Discussion: e study will provide data to evaluate structural aspects and

quality criteria of KBS and describe changes compared to 2015/2016.

Conclusions: e data can be used to assess the situation of the KBS

in Germany in the context of the nancial contribution of the health

insurance funds and to discuss implications for further improved

implementation.

Disclosure Statement: e authors declare no conict of interest.

874

Dyadic coping of cancer patients and their partners: How does

it aect therapy adherence?

Anne-Kathrin Köditz1; Peter Hövel1; Anja Mehnert-Theuerkauf1;

Lisa Cossmann1; Ute Goerling2; Charis Haering3; Myriel Hermann2;

Beate Hornemann3; Hannah Reuter4; Tanja Zimmermann4; Jochen Ernst1

1Universitätsklinikum Leipzig/Medizinische Psychologie und Medizinische

Soziologie, Leipzig, Deutschland

2Charité Comprehensive Cancer Center, Charité - Universitätsmedizin Berlin,

Berlin, Deutschland

3Psychoonkologie, NCT/UCC - Nationales Centrum für Tumorerkrankungen

Dresden, Dresden, Deutschland

4Klinik für Psychosomatik und Psychotherapie, MHH - Medizinische Hochschule

Hannover, Hannover, Deutschland

Background: Coping of couples in which one partner is aected by cancer

is considered as a dyadic process (dyadic coping, DC). Little research has

examined the dependence of therapy-associated factors on the DC and on

the degree to which the two partners rate the DC in agreement (congru-

ence index, CI). We aim to identify the relationship between DC and CI in

patient-partner dyads and therapy adherence.

Methods: We report data from the study “Prevalence of mental disorder,

psychosocial distress and need for psychosocial support in cancer patients

and their relatives stratied by biopsychosocial factors”. We analyze the

rst measurement time point within < 8 weeks aer diagnosis of a solid

cancer (t1) and the second 6 months aer t1 (t2). We used validated ques-

tionnaires (Dyadic Coping Inventory, dimensions of DC: positive, nega-

tive, delegated, common; Adherence Assessment Questionnaire). Analysis

was carried out using a logistical regression (DV: therapy adherence, IV:

DC and CI, medical and sociodemographic variables).

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 191

Result: We analyze 210 couples (patients: 63.8% men; average age 60.2y;

78.6% married). Most prevalent cancers were prostate (32.4%), breast

(12.9%) and skin cancer (7.1%). Signicant correlations as well as medium

and strong eect sizes (Cohens d) were found between the dyadic coping

of the patient and the partner at t1. e discrepancy between self-assess-

ment and external assessment of the DC mostly correlated signicantly

with r < .31. e average of therapy adherence at t2 was 1.85 (SD: 0.56;

Range: 1=good therapy adherence to 4=very high probability of non-ad-

herence). Multivariate relationships between therapy adherence and DC

will be presented at the congress.

Discussion: We aim to determine the extent to which the DC dimen-

sions and the CI of cancer patients and their partners inuence therapy

adherence.

Conclusion: e clinical implications for psycho-oncology care of a

possible link between dyadic coping as a resource to increase treatment

adherence will be discussed.

Disclosure Statement: e authors declare no conict of interest.

877

Supporting Shared Decision Making: Measuring AI-based

prediction of trust based on the patients behaviour

Serap Tari1,2; Andreas Klostermann3; Julian Koller4; Friederike Mumm5;

Kristian Unger1; Claus Belka1

1LMU Klinikum / Klinik für Strahlentherapie und Radioonkologie,

München, Deutschland

2Bayerisches Zentrum für Krebsforschung (BZKF), München, Deutschland

3Trust Driven, München, Deutschland

4Hochschule der Bayerischen Wirtschaft gGmbH, München, Deutschland

5LMU Klinikum / CCC LMU Psychoonkologie / Medizinische Klinik III,

München, Deutschland

Purpose: Patient trust in doctors plays a central role in medical encoun-

ters, particularly with respect to shared decision making (SDM). Little is

knownabout whether the dimension of patient trust in the doctor-patient

relationship can be predicted by using AI-based models based on patients

behaviour. e aim is to empower patients in order to have a positive

eect on SDM in oncology. We searched the literature to assess the rele-

vance of this topic.

Methods and Materials: Systematic PubMed literature search was con-

ducted using the following MeSH terms: “Cancer”, “oncology”, “trust”,

“decision”, “decision making, shared”, “condence” and “intelligence,

articial”. PubMed hits were analysed for their relevance and classied

into the categories: Global publications on the topic, publications pro-

posing methods to measure trust, publications where SDM outcome

and trust have been correlated and articial intelligence (AI) in SDM as

such and specically in oncology. PubMed metrics were analysed using

Bibliometrix.

Results: SDM in oncology (MeSH terms) made its entry into PubMed in

2018. e topic has an average growth rate of 44% per year since then with

an actual total of 338 publications. 18 out of 338 publications were on AI

in SDM in general, one was on AI in oncological SDM. However, only four

out of those, in addition, were on patient trust. Four of the publications

aim to measure trust. None of them measure it by analysing the patient’s

behaviour. e most relevant keywords related to SDM in oncology

among cancer-related terms were communication, patient engagement,

and cancer screening.

Conclusion: Overall, while SDM in oncology becomes growingly import-

ant in biomedical research, as well as AI in SDM, the relevance of research

in terms of trust as a dimension and its potential in oncology has not

really been reected in recent years. So far, there are only few attempts to

structurally determine trust at all. Hence, our proposed approach to use

a KI-model for trust prediction promises potential for the deeper under-

standing and improvement of SDM in oncology.

Disclosure Statement: e authors declare no conict of interest.

878

Motives for using and recommending cancer counseling

centers – A multicenter qualitative study

Melanie Schranz1,2; Oliver Bayer1,2; Margret Xyländer3; Markus Besseler4;

Hanna Bohnenkamp5; Gudrun Bruns6; Norbert Gelse7; Andreas Ihrig8;

Silke Meier9; Franziska Petridis10; Evelyn Flohr-Schmitt11;

Alexander Wünsch12,13; Thorsten Meyer-Feil14; Susanne Singer1,2

1Institut für Medizinische Biometrie, Epidemiologie und Informatik (IMBEI),

Universitätsmedizin der Johannes Gutenberg-Universität, Mainz, Deutschland

2Universitäres Centrum für Tumorerkrankungen (UCT), Universitätsmedizin der

Johannes Gutenberg-Universität, Mainz, Deutschland

3Humboldt-Universität zu Berlin, Institut für Rehabilitationswissenschaften,

Berlin, Deutschland

4Bayerische Krebsgesellschaft e.V., München, Deutschland

5Hessische Krebsgesellschaft e.V., Frankfurt, Deutschland

6Tumor-Netzwerk Krebsberatung im Münsterland e.V., Münster, Deutschland

7zum Zeitpunkt der Studie Psychosoziale Krebsberatungsstelle,

Universitätsklinikum Tübingen, Tübingen, Deutschland

8Psychosoziale Krebsberatungsstelle Nordbaden, Universitätsklinikum

Heidelberg, Klinik für Allgemeine Innere Medizin und Psychosomatik,

Heidelberg, Deutschland

9Psychoonkologin Hamburg, zum Zeitpunkt der Studie Stiftung phönikks,

Hamburg, Deutschland

10Psychosoziale Beratungsstelle für Krebskranke und Angehörige, Karlsruhe,

Deutschland

11zum Zeitpunkt der Studie Bayerische Krebsgesellschaft e.V., München,

Deutschland

12Inselspital/Universitätsspital Bern, Medizinische Onkologie,

Psychoonkologischer Dienst, Bern, Schweiz

13Psychosoziale Krebsberatungsstelle am Tumorzentrum Freiburg - CCCF in

Kooperation mit dem Universitätsklinikum Freiburg, Freiburg, Deutschland

14Universitätsmedizin Halle, Institut für Rehabilitationsmedizin, Halle (Saale),

Deutschland

Background: Cancer patients and their relatives face not only physical

but also psychosocial problems and challenges as a result of the disease.

Cancer counseling centers (German: Krebsberatungsstellen, KBS) oer

psychosocial support, however are not always used by those in need. What

makes patients and relatives as well as health care providers open to use

respective recommend it?

Methods: Semi-structured interviews were conducted in a Germany-wide

qualitative study. A total of 43 patients and relatives were interviewed face-

to-face by trained sta in 10 KBS; 30 referrers (i.e. physicians, psychother-

apists) were interviewed via telephone. All interviews were transcribed

verbatim and analyzed by means of thematic coding sensu Mayring.

Result: Patients and relatives seek KBS because they suer from dierent

straining conditions such as anxiety, helplessness, despair and disorien-

tation. ere were clients who mainly looked for professional support to

clarify socio-legal issues and bureaucratic matters and to talk to someone

outside their family or social environment to work through their emo-

tional problems. Referrers recommend KBS to provide help to patients

soon aer hospital discharge and when longer-term or intermittent sup-

port is needed in the outpatient setting. Respondents also indicated their

recommendation of KBS due to not having the professional expertise

regarding psycho(onco)logical or socio-legal issues. In addition, limited

time and sta resources were claimed as resulting in referrals to KBS.

Discussion: KBS are used or recommended for various reasons, especially

when psychosocial support is needed. Patients and relatives want to talk

to someone without burdening their family with their worries. is is

also a motive for the referring health care providers as they themselves

oen do not have adequate time for longer conversations with patients

and relatives.

Conclusion: KBS are used and recommended because they provide valu-

able psychosocial support and relieve not only patients and relatives, but

also referring health care providers.

Disclosure Statement: e authors declare the following: M. Schranz, O. Bayer,

M. Xyländer und T. Meyer-Feil geben an, dass kein Interessenkonikt besteht.

S. Singer erhielt Honorare für wissenschaliche Vorträge und Gutachten von Lilly

und Pzer – alle außerhalb der hier vorgestellten Studie. M. Besseler, H. Bohnen-

kamp, G. Bruns, N. Gelse, A. Ihrig, S. Meier, F. Petridis, E. Flohr-Schmitt und

A. Wünsch waren bzw. sind selbst Mitarbeiter/innen einer Krebsberatungsstelle.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts192

Radiation

Change in Tumor Volume at Boost Planning to Predict

Response to Chemoradiotherapy in inoperable stage III NSCLC

(TORCH study)

Simon Trommer1; Jörg-Andreas Müller1; Michael Oertel2; Felix Ehret3,4;

Siyer Roohani4; Tim Lange5; Matthias Mäurer6; Hai Minh Ha7; Quynh Ngo7;

Sophie Dobiasch8,9,10; Justus Domschikowski11; Eleni Gkika12;

Kathrin Hering13; Thomas Kuhnt13; Davide Scafa14; Maike Trommer15;

Maria Waltenberger8,10; Dirk Vordermark1,7; Daniel Medenwald1,7

1Universitätsklinik und Poliklinik für Strahlentherapie, Universitätsklinikum Halle

(Saale), Halle (Saale), Deutschland

2Klinik für Strahlentherapie - Radioonkologie, Universitätsklinikum Münster,

Münster, Deutschland

3Klinik für Radioonkologie und Strahlentherapie, Charité, Universitätsmedizin

Berlin, Berlin, Deutschland

4Klinik für Radioonkologie und Strahlentherapie, Charité - Universitätsmedizin

Berlin, Berlin, Deutschland

5Klinik für Strahlentherapie und spezielle Onkologie, Medizinische Hochschule

Hannover, Hannover, Deutschland

6Klinik für Strahlentherapie und Radioonkologie am Universitätsklinikum Jena,

Jena, Deutschland

7Universitätsklinik für Strahlentherapie, Universitätsklinikum Magdeburg A. ö. R.,

Magdeburg, Deutschland

8Klinik und Poliklinik für RadioOnkologie und Strahlentherapie am Klinikum

rechts der Isar, Technische Universität München, München, Deutschland

9Institut für Strahlenmedizin (IRM), Helmholtz Zentrum München, Neuherberg,

Deutschland

10Deutsches Konsortium für Translationale Krebsforschung (DKTK), Partner Site

Munich, München, Deutschland

11Klinik für Strahlentherapie (Radioonkologie), Universitätsklinikum

Schleswig-Holstein, Campus Kiel, Kiel, Deutschland

12Klinik für Strahlenheilkunde, Universitätsklinikum Freiburg, Freiburg im

Breisgau, Deutschland

13Klinik und Poliklinik für Strahlentherapie, Universitätsklinikum Leipzig, Leipzig,

Deutschland

14Klinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Bonn,

Bonn, Deutschland

15Klinik und Poliklinik für Radioonkologie, Cyberknife- und Strahlentherapie,

Universitätsklinikum Köln, Köln, Deutschland

Background: In stage III non-small cell lung cancer (NSCLC), the use of

consolidating immunotherapy aer chemoradiotherapy (CRT) has shown

improved progression-free survival (PFS) and overall survival (OS). e

gross tumor volume (GTV) obtained from the boost planning computer

tomogram (BPCT) has been identied as a strong predictor of OS. e

TORCH study aims to investigate whether the GTV response at the time

of boost planning CT can serve as a predictor for durvalumab response.

Methods: is multicenter retrospective study evaluates the primary

endpoint of non-progression according to RECIST 1.1 criteria in patients

undergoing CRT in stage III NSCLC with a minimum cumulative dose of

60 Gy. Patients with WHO performance status ≥2, immunosuppression or

prior treatment with anti-PD1 or anti-PD-L1 antibodies were excluded.

GTV1 was dened at the beginning of CRT, GTV2 in the BPCT. Cox

regression was performed to assess the inuence of GTV change on PFS

and OS.

Result: e analysis included 139 patients so far, with 48 patients receiv-

ing durvalumab immunotherapy aer CRT. So far, no signicant impact

of GTV or its relative size change during CRT on PFS and OS could be

demonstrated. Within the subgroup of patients treated with durvalumab,

a trend towards improved PFS was observed in patients with greater GTV

shrinkage (p=0.059).

Discussion: While the trend towards improved survival in patients with

greater tumor shrinkage is promising, it did not reach statistical signi-

cance in this analysis. e ongoing recruitment of 200 patients may help

clarify this trend further. If the current trend is conrmed, early con-

solidation of immunotherapy aer CRT could be considered, given the

observed non-progression during the BPCT.

Conclusion: Recruitment is ongoing, and with the expected completion

of patient enrollment, the study aims to clarify the role of GTV response

as a predictor for durvalumab response in patients with stage III NSCLC.

Disclosure Statement: e authors declare the following: Forschungsunterstützung

durch AstraZeneca GmbH.

379

Patient Safety in German Radiation Oncology (PaSaGeRO) -

Development of an assessment instrument for patient safety

Andrea Baehr1; Eva Christalle2; Maximilian Grohmann1; Isabelle Scholl2

1Klinik für Strahlentherapie und Radioonkologie Universitätsklinikum

Hamburg-Eppendorf, Hamburg, Deutschland

2Institut und Poliklinik für Medizinische Psychologie Universitätsklinikum

Hamburg-Eppendorf, Hamburg, Deutschland

Purpose: Ensuring the quality of all steps in the radiotherapy process is

essential to safeguard the success of modern radiotherapeutic approaches.

Errors within this process can lead to adverse events, potentially even to

fatal outcomes. Consequently, the issue of patient safety (PS) within radi-

otherapy holds signicant importance. is study aims to establish a set

of PS indicators tailored specically for radiotherapy and develop a ques-

tionnaire for their assessment.

Methods: is mixed-method study is funded by the German Cancer Aid

as a multi-centre collaborative project spanning three years. We are cur-

rently conducting a literature review to identify potential PS indicators.

Subsequently, we will nalize PS indicator set through focus groups and

a Delphi study involving experts from all relevant professional groups.

Next, we will design and psychometrically assess a questionnaire intended

to evaluate these indicators, involving a minimum of n=153 participants

across multiple departments. Finally, we will assess the feasibility of

implementing the questionnaire in routine care.

Results: e project will yield a set of PS indicators grounded in a com-

prehensive literature review and validated by an expert panel. Moreover,

it will provide a psychometrically robust questionnaire for evaluating PS.

e trial implementation will allow us to identify barriers and facilita-

tors for questionnaire utilization. Additionally, we aspire to develop the

questionnaire into a digital tool, that highlights weaknesses and potential

enhancements within an institution.

Discussion and Conclusion: is project systematically addresses PS in

German radiotherapy. It introduces, for the rst time, the opportunity

to evaluate safety-eective processes and structures within individual

departments. e digital tool empowers professionals to self-assess PS

in their institutions conveniently. Furthermore, it contributes to raising

awareness of safety-related matters and enables institutions to compare

their processes with national and international recommendations.

Disclosure Statement: e authors declare no conict of interest.

415

Stereotactic Body Radiation Therapy (SBRT)in Functionally

Inoperable Patientswith Clinically Diagnosed Early-Stage

Lung Cancer: a Retrospective Single-Center Analysis

Karim El-Marouk; Julian Taugner; Esra Degerli; Lukas Käsmann;

Farkhad Manapov; Chukwaka Eze

LMU Klinikum Campus Großhadern, München, Deutschland

Background: Stereotactic body radiotherapy (SBRT) is the gold stand-

ard for early-stage lung cancer without surgical option. However, these

patients are oen unable to undergo biopsy due to increased risk asso-

ciated with advanced age or high comorbidity. erefore, clinical, and

radiological criteria indicating malignancy must be applied. is study

aimed to evaluate the ecacy and safety of empiric SBRT in presumed

early-stage lung cancer.

Methods: We performed a retrospective analysis of 57 patients with inop-

erable and clinically diagnosed lung cancer stage I/II. All patients were

treated with empiric SBRT without preceding biopsy. We included patient,

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 193

tumor, and treatment characteristics into the analysis to evaluate a possi-

ble association with overall survival.

Result: Median age at diagnosis was 70 years. Median follow up was 50.2

months and median overall survival was 41.7 months. Local control aer

1 year was 89%, and aer 2 years 77%. Most of the tumors were located

peripheral (64.9%). Central (28.1%) and ultra-central (7.0%) were seen

in less patients. Only one-fourth of patients reported new-onset dysp-

nea within the rst week aer SBRT. Among patients with an increase

in subjective dyspnea, median PFS was 16.6 vs. 32.7 months (p=0.004).

Furthermore, patients with newly developed suspicious lymph nodes aer

therapy had a signicantly inferior OS of 19.9 months vs. 69.2 months

(p= 0.045). All patients received SBRT to a BED of at least 100 Gy.

Discussion: In fact, most of the data found in the literature are pooled,

meaning that both patients with biopsy-proven disease and those without

a performed biopsy are included. All patients taken into our evaluation

were non-biopsy-proven due to their low tness.

Conclusion: Under the condition of an already poor prognosis in the

multimorbid population, empirical SBRT in presumed early-stage lung

cancer has been shown to be ecient and safe. Patients with newly devel-

oped suspicious lymph nodes in imaging aer therapy had a signicantly

inferior OS.

Disclosure Statement: e authors declare no conict of interest.

528

State of Digitalization in Radiation Oncology Departments:

Insights into Germany, Austria, and Switzerland by 2023

Maximilian Grohmann1; Stefan Janssen2; Rami El Shae3; Andrea Baehr1;

Sarah Stefanowicz4; Paul Martin Putora5; Stefan Knippen6; Marcus Beck7;

Patrick Clemens8

1Universitätsklinikum Hamburg-Eppendorf, Klinik für Strahlentherapie und

Radioonkologie, Hamburg, Deutschland

2Universitätsklinikum Schleswig-Holstein, Campus Kiel, Klinik für

Strahlentherapie, Lübeck, Deutschland

3Universitätsmedizin Göttingen (UMG), Klinik für Strahlentherapie und

Radioonkologie, Göttingen, Deutschland

4Medizinische Hochschule Hannover, Klinik für Strahlentherapie und Spezielle

Onkologie, Hannover, Deutschland

5Kantonsspital St. Gallen, Klinik für Radio-Onkologie, St. Gallen, Schweiz

6Helios Kliniken Schwerin, Klinik für Strahlentherapie, Schwerin, Deutschland

7Charité Universitätsmedizin Berlin, Klinik für Strahlentherapie und

Radioonkologie, Berlin, Deutschland

8Landeskrankenhaus Feldkirch, Abteilung für Strahlentherapie und

Radio-Onkologie, Feldkirch, Österreich

Background: Digitalization is revolutionizing healthcare, particularly

inuencing elds like radiation oncology where it enhances treatment

planning and elevates patient engagement. Understanding this digital

adoption is critical. Our study aims to assess this in German-speaking

radiation oncology departments.

Methods: A digital survey was conducted, consisting of 53 questions

that covered various aspects of digitalization including patient workow,

departmental organization, radiotherapy planning, and employee-related

aspects. e corresponding survey link was sent to all DEGRO (Deutsche

Gesellscha für Radioonkologie) -associated radiation oncology depart-

ments across Germany, Austria, and Switzerland.

Results: From the 354 clinics invited to participate, we received 120

forms that were eligible for analysis, yielding a response rate of 33%. Most

responses were contributed by physicians and medical physicists who are

at the forefront of digital transformation within their organizations. e

survey disclosed a diverse digital adoption landscape: Nearly 70% of the

responding departments have integrated electronic patient records, and

around 50% operate without paper. In contrast, more advanced digital

solutions like smartphone apps for patient-reported outcomes or special-

ized digital health platforms are seldom used. ere’s also a discernible

trend towards employing automated tools for tasks such as contouring

and treatment planning. Note: ese are selected key ndings.

Discussion: e survey underscores an uneven digital maturity in

German-speaking radiation oncology. Foundational systems like

electronic records are well-integrated, yet innovative tools lag behind. is

mismatch aligns with broader trends in German healthcare, highlighting

a need for focused advancement in cutting-edge digital solutions.

Conclusion: Our survey oers a snapshot of digital adoption, pointing

out both strengths and areas for targeted improvement. It serves as a guide

for DEGRO and policymakers, aiming to elevate the standard of care in

radiation oncology.

Disclosure Statement: e authors declare no conict of interest.

551

Automatized response-adaptive radiotherapy with integrated

patient-feedback for lung cancer

Susanne Schrof; Marcel Nachbar; Goda Kalinauskaite; Marcus Beck;

Sebastian Zschaeck; Daniel Zips; Carolin Senger

Charite, Klinik fuer Strahlentherapie und Radioonkologie, Berlin, Deutschland

Purpose: Dose escalation in standard chemoradiotherapy and sequential

immunotherapy for stage III NSCLC is limited by radiation induced tox-

icity. Adaptive radiation therapy (ART) is a new image-guided technology

that avoids overexposure of surrounding normal tissue by optimizing the

radiotherapy (RT) plan according to tumor shrinkage and intrathoracical

anatomical changes on a daily basis. Currently, due to associated increased

workload and economic burden, ART is not yet integrated in standard clini-

cal treatment. e aim of this study is to develop a digital workow that com-

bines autonomous image segmentation and RT planning tools with patient

feedback for an individualized, fast, systematic and automatized treatment.

Methods: In this prospective, non-interventional study, we apply

AI-based image segmentation on cone-beam CTs to analyze the tumor

volume and depict the thoracic anatomy of the day. We are monitoring the

radiation induced toxicity on a weekly basis using ePROMs and ePRTs.

An autonomous planning tool integrates anatomical changes and toxicity

and optimizes the RT plan accordingly.

Results: Our preliminary results from 10 included patients visualize sig-

nicant anatomical alterations, especially the volumetric tumor shrinkage,

which is up to 50% during RT. A gradual increase of treatment toxicities,

such as esophagitis, pain and fatigue can be observed in ePROMs and

ePRTs. We are dening anatomical and symptomatic triggers to RT plan

adaptations. Currently, we are estimating the actual dose to tumor, sur-

rounding lung tissue, heart and esophagus in conventional RT and are

simulating the ART dose reduction to these OARs.

Discussion: is non-interventional study oers a novel ART strategy by

involving not only daily imaging, but also patient feedback to reduce radi-

ation-induced toxicity. We hypothesize that ART can reduce OAR dose by

approximately 15%.

Conclusions: e overall goal of this study is to increase the local tumor

control rate, reduce radiation-induced toxicity and improve the overall

patient survival in future interventional studies.

Disclosure Statement: e authors declare no conict of interest.

647

Radiation-induced senescence in cancer-associated

broblasts

Nadine Wiesmann-Imilowski1,2; Rita Gieringer1,2; Johannes Kupka2;

Victoria Langer1; Sebahat Kaya1; Peer Kämmerer1; Juergen Brieger2

1University Medical Center Mainz, Oral and Maxillofacial Surgery, Plastic

Surgery, Mainz

2University Medical Center Mainz, Otorhinolaryngology, Mainz

Background: Strategies for tumor treatment were focused solely on tumor

cells for a long time. However, the complex tumor microenvironment has

signicant inuence on tumor progression. If radiotherapy is chosen,

which is the case in about half of all patients, then inevitably also the

adjacent cells such as cancer-associated broblasts (CAFs), are exposed

to radiation. Since it is well known that CAFs play an important role in

tumor progression, we investigated their reaction to radiotherapy.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts194

Methods: For our study we isolated primary CAFs from oral squamous

cell carcinoma tissue. ese cells were exposed to dierent radiation

regimes ranging from single-high-dose irradiation to fractionated mod-

els. Besides the analysis of cell death and radiation-induced senescence,

we also analysed the secretory phenotype.

Result: We found that CAFs exhibit a high level of radioresistance. Instead

of dying CAFs entered radiation-induced senescence. is state was char-

acterised by an increased beta-galactosidase activity and an arrest of the

cell cycle. Furthermore, a typical senescence-associated secretory phe-

notype (SASP) was observed. Senescence was initiated within one week

aer irradiation with a single dose of 16 Gy and observations over 50 days

showed the prolonged persistence of this condition.

Discussion: Senescence can have pro-tumorigenic eects which are

believed to be largely due to the secretion of various modulating factors

as part of the SASP. We were able to show here that senescent CAFs are

a rich source of secreted growth factors, which can facilitate tissue repair

through the modulation of immune responses and angiogenesis. However,

in a tumor context they might facilitate invasion, metastasis, angiogenesis,

and evasion from immunosurveillance.

Conclusion: A better understanding of the reaction of CAFs to radiother-

apy could help to intervene in these processes and prevent the development

of local recurrences and metastasis to distant sites following radiotherapy.

Disclosure Statement: e authors declare no conict of interest.

704

Clinical Experience of Dose escalated Intensity modulated

Proton Therapy for Skull Base/Cervical Spine Chordoma:

Results of the prospective ProReg and KiProReg studies

Dalia Ahmad Khalil1; Christian Bäumer2,3; Jörg Wul3; Zaneera Asim3;

Moritz Meyer4; Benjamin Kansy4; Kerstin Stähr4; Stefan Mattheis4;

Stephan Lang4; Sebastian Bauer5; Beate Timmermann3,6

1Department of Particle Therapy, West German Proton Therapy Centre Essen

(WPE), West German Cancer Center (WTZ), University Hospital Essen, Essen,

Deutschland

2Department of Physics, TU Dortmund University, Dortmund, Deutschland

1Department of Particle Therapy, West German Proton Therapy Centre Essen

(WPE), West German Cancer Center (WTZ), University Hospital Essen, Essen,

Deutschland

4Department of Otorhinolaryngology, Head and Neck Surgery, University

Hospital Essen, Essen, Deutschland

5Department of Medical Oncology, Sarcoma Center, West German Cancer

Center (WTZ), University Hospital Essen, Essen, Deutschland

6German Cancer Consortium for Translational Cancer Research (DKTK),

Heidelberg, Deutschland

Background: e study aimed to analyse the results of dose escalated

intensity-modulated Proton therapy (IMPT) in management of skull-base

and/or cervical spine chordoma.

Methods: Between 03/2016 and 01/2023, 53 patients with skull-base and/

or cervical spine chordoma underwent moderately hypofractionated

dose escalated IMPT. All patients included in the prospective ProReg

and KiProReg studies at West German Proton erapy Centre. IMPT

was implemented with an SIB schedule with5 x 2.1 Gy(RBE)/week to

73.5 Gy(RBE) for the high-dose volume, and 5 x 1.6 Gy(RBE)/week to 56

Gy(RBE) for the low-dose volume.

Result: Median age at radiotherapy was 54.8 years (range 2.7- 82.6 y).

Prior to radiotherapy, 4 patients underwent biopsy, 46 patients STR, and

3 patients GTR. ree patients out of 4 with undierentiated chordoma

received chemotherapy prior to radiotherapy. At the last follow-up (FU), 49

patients had median FU time of 33 months (range 6-80.7 months). irty

eight (77.6%) patients were progression-free. Four (8.2%) patients died

due to tumor-related causes, 11 (22.4%) patients developed progression

of the disease, 8 (16.3%) local recurrence, and 5 (10.2%) metastases, 3 of

them (6.1%) developed intraspinal metastases, and 2 (4.1%) surgical tract

metastases. Estimated 6-y OS, PFS, LRFS, and DMFS were 82%, 63.4 %,

74.8%, and 80.3 %, respectively. Patients with undierentiated chordoma

and unexpected chondroid chordoma had worse OS results in compari-

son to conventional chordoma (p<0.001). No dierence in survival results

regarding resection status. No Grade 3 late toxicities were observed.

Discussion: We reported good oncological results in comparison with

published trials.

Conclusion: Dose escalated proton therapy with IMPT-SIB is safe and

eective option in treatment of skull-base and/or cervical spine chor-

doma. Despite advances in surgical and radiotherapy techniques, local

and systemic control of chordoma is still challenging and raising the issue

about role of systemic therapy in treatment of chordoma.

Disclosure Statement: e authors declare no conict of interest.

705

Implementation of PET/CT in radiation oncology – a patterns-

of-care analysis of the German Society of Nuclear Medicine

(DGN) and the German Society of Radiation Oncology

(DEGRO)

Simone Wegen1; Ursula Nestle2,3; Constantinos Zamboglou3; Simon Kb

Spohn4,5; Nils Henrik Nicolay6; Wolfgang Fendler7; Adrien Holzgreve8;

Rudolf Werner9; Nina-Sophie Schmidt-Hegemann10

1Department of Radiation Oncology, Cyberknife and Radiotherapy, Faculty of

Medicine and University Hospital Cologne, Cologne, Deutschland

2Kliniken Maria Hilf GmbH, Mönchengladbach, Deutschland

3Department of Radiation Oncology, University Hospital Freiburg, Freiburg im

Breisgau, Deutschland

4Faculty of Medicine - University of Freiburg, Berta-Ottenstein-Programme,

Freiburg, Freiburg im Breisgau, Deutschland

5Department of Radiation Oncology, University Hospital Freiburg, Freiburg im

Breisgau, Deutschland

6Department of Radiation Oncology, University Hospital Leipzig, Leipzig,

Deutschland

7Department of Nuclear Medicine, University Hospital Essen and PET

Committee of the DGN, Essen, Deutschland

8Department of Nuclear Medicine, LMU University Hospital, LMU Munich and

PET Committee of the DGN, Munich, Deutschland

9Department of Nuclear Medicine, University Hospital Würzburg, Würzburg,

Deutschland

10Department of Radiation Oncology, LMU University Hospital, LMU Munich,

Munich, Deutschland

Background: Use of PET/CT in radiation therapy (RT) has increased.

Radiation oncologists (RadOncs) have access to PET/CT with a variety

of tracers and use it for target volume denition. e German Society of

Nuclear Medicine (DGN) and the German Society of Radiation Oncology

(DEGRO) aimed to identify current patterns-of-care to improve interdis-

ciplinary collaboration.

Methods: We created a survey on participating RadOncs’ use of dif-

ferent PET tracers for tumor delineation and treatment planning. We

queried organizational information (xed time slots, use of PET with

immobilization device (RT-PET), nancial compensation) and used the

Likert-Scale for multiple-choice questions and a free text entry option

in multiple-select questions. e survey was distributed via the DEGRO

members mailing list.

Result: During the survey period (May 22nd - August 7th, 2023), a total of

156 RadOncs participated. Among these, 59% reported access to diagnos-

tic PET/CT within their organization/clinic and 24% indicated xed time

slots for their patients. 37% perform RT-PET and 29% stated the presence

of a a dedicated RT-technician during the examination. Beside FDG (high-

est use in lung cancer: 95%), diagnostic PSMA-PET/CT for RT of prostate

cancer is routinely used by 44% (64% in salvage-RT). Use of amino acid

PET in brain tumors and somatostatin receptor PET in meningioma is

low (19% and 25%, respectively). Scans are reimbursed through the pri-

vate health insurance (75%) or within the indications approved by the joint

federal committee (GBA, 59%). 98% of RadOncs agreed that PET impacts

target volume denition and 62% indicated an impact on RT dose. Nearly

8% of surveyed RadOncs used auto contouring in PET-planned RT.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 195

Discussion: is is the rst nationwide survey on the role of PET/CT

among RadOncs in Germany. We nd a high acceptance of PET results

for target volume denition and a high implementation also of PET trac-

ers beyond FDG.

Conclusion: PET/CT has become an important tool for RadOncs with

several indications. However, access is limited in several sites, especially

to dedicated RT-PET.

Disclosure Statement: e authors declare no conict of interest.

709

Long-term vision preservation after proton beam therapy in

patients with iuxta-foveal uveal melanoma

Johannes Gollrad1; Ysé Barreau1; Andreas Weber2; Antonia Joussen2;

Daniel Zips1; Alexander Böker2

1Klinik für Radioonkologie und Strahlentherapie, Charité - Universitätsmedizin

Berlin, Berlin, Deutschland

2Klinik für Augenheilkunde, Charité - Universitätsmedizin Berlin, Berlin,

Deutschland

Background: Although excellent local control and eye retention rates

are achieved with ocular proton beam therapy (PBT), long-term vision

preservation is oen challenging in patients with iuxta-foveal tumor loca-

tions. Despite the proximity of these tumors to the fovea (0-5 mm), some

patients present with good-to-normal vision at diagnosis. erefore, the

avoidance of severe radiation induced visual deterioration is a crucial

treatment objective. We investigated whether the unique dose-sparing

ability of PBT translates into vision preservation in these patients.

Methods: We reviewed tumor characteristics and visual acuity data of

patients with iuxta-foveal uveal melanoma located 0-5 mm from the fovea

and >4 mm from the optic disc, who presented with best-corrected visual

acuity (BCVA) >0.5 decimals at baseline and underwent curative PBT

with 60 CGE as primary treatment. We performed Time-to-event and cox

proportional hazard analyses to investigate the impact of tumor location

on vision preservation and to identify potential risk factors for visual dete-

rioration aer PBT.

Result: In total, 74 patients (mean age 64.2, median follow-up 76 months)

were included into the analyses. In patients with a tumor distance >2 mm

from the fovea, the mean initial BCVA changed from 0.93 (SD 0.21) to 0.7

(SD 0.29) decimals 5 years aer PBT. In patients with a tumor location

<1 mm from the fovea, mean BCVA deteriorated from 0.86 (SD 0.19) dec-

imals to 0.22 (SD 0.20) at 5 years. Cox regression identied the distance to

the fovea >1 mm as the most relevant factor for vision preservation (HR

0.32, 95% CI 0.13-0.78, p=0.013).

Discussion: Due to its precision, ocular PBT provides protection to the

central foveal areas and eectively contributes to the preservation of long-

term vision in patients with uveal melanoma in close proximity to the

fovea. is is only applicable to patients in whom the optic disc is not

exposed to irradiation.

Conclusion: Aer PBT, excellent visual outcomes are achieved in patients

with iuxta-foveal uveal melanoma >2 mm from the fovea.

Disclosure Statement: e authors declare no conict of interest.

717

Proton Therapy for Skull-Base/Cervical Spine

Chondrosarcoma: Results of the Prospective ProReg and

KiProReg studies

Dalia Ahmad Khalil1; Christian Bäumer1,2; Jörg Wul1; Moritz Meyer3;

Theresa Steinmeier1; Zaneera Asim1; Benjamin Kansy3; Kerstin Stähr3;

Stefan Mattheis3; Stephan Lang3; Sebastian Bauer4; Beate Timmermann1,5

1Department of Particle Therapy, West German Proton Therapy Centre Essen

(WPE), West German Cancer Center (WTZ), University Hospital Essen, Essen,

Deutschland

2Department of Physics, TU Dortmund University, Dortmund, Deutschland

3Department of Otorhinolaryngology, Head and Neck Surgery, University

Hospital Essen, Essen, Deutschland

4Department of Medical Oncology, Sarcoma Center, West German Cancer

Center (WTZ), University Hospital Essen, Essen, Deutschland

5German Cancer Consortium for Translational Cancer Research (DKTK),

Heidelberg, Deutschland

Background: To evaluate ecacy and safety of intensity-modulated

proton therapy with simultaneous integrated boost (IMPT-SIB) in

denitive or adjuvant management of skull-base and/or cervical spine

chondrosarcoma.

Methods: In the prospective ProReg and KiProReg studies, 31 patients

with skull-base and/or cervical spine chondrosarcoma underwent IMPT-

SIB at West German Proton erapy Centre between 01/2017 and 01/2023.

SIB schedule for denitive/additive radiotherapy was5 × 2.1 Gy(RBE)/w

to 69.3 Gy(RBE) for the high-dose volume, and 5 × 1.65Gy(RBE)/w to

54.45 Gy(RBE) for the low-dose volume. In the adjuvant setting, 5 ×

2.1 Gy(RBE)/week to 67.2 Gy(RBE) for the high-dose volume, and 5 ×

1.7 Gy(RBE)/week to 54.4 Gy(RBE) for the low-dose volume were

prescribed.

Result: 67.7% of patients received proton therapy at initial diagnosis and

32.2% were irradiated at recurrence. Prior to radiotherapy, two patients

underwent biopsy only, 26 patients STR, and three patients GTR. Two

patients missed oncological follow-Up (FU). For the remaining 29

patients the median FU time was 39.9 months and ranged between 5.45–

73.46 months. ree patients died during FU, in one patient the cause of

death was tumor-related and in two patients was not tumor-related. Two

patients developed local recurrence and no patients developed metastasis.

Estimated 6-y OS, DSS, and PFS were 80%, 91.7%, and 90.8%, respec-

tively. No Grade 3 late toxicities (cranial nerves/brainstem/temporal

lobes/spinal cord or brain complications) were observed.

Discussion: Published data of proton therapy in management skull-base

and/or cervical spine chondrosarcoma are sparse due to rarity of the dis-

ease and unavailability of the complex technique in most centers. Our

Results are comparable with the published literature.

Conclusion: IMPT-SIB is safe and eective in treatment of skull-base

and/or cervical spine chondrosarcoma not only as an adjuvant to surgery

but also in the denitive setting.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts196

734

Investigation of Radiation Sensitization in Patient-Derived

Head and Neck Squamous Cell Carcinoma Organoids

Lena Heiser1,2; Soňa Michlíková2,3; Antje Dietrich1,2; Claudia Ball1,4,5,6;

Dominik Haim6,7; Max Kemper6,8; Korinna Jöhrens9; Ivona Mateska6;

Mechthild Krause1,2,3,6,10; Annett Linge1,2,6,10; Daniel Stange6,11;

Elisa Thomas1,2,6,10

1German Cancer Consortium (DKTK), Partner Site Dresden, and German Cancer

Research Center (DKFZ), Heidelberg, Dresden, Deutschland

2OncoRay – National Center for Radiation Research in Oncology, Faculty of

Medicine and University Hospital Carl Gustav Carus, TUD, Helmholtz-Zentrum

Dresden – Rossendorf, Dresden, Deutschland

3Helmholtz-Zentrum Dresden - Rossendorf, Institute of Radiooncology -

OncoRay, Dresden, Deutschland

4Translational Medical Oncology, Faculty of Medicine and University Hospital

Carl Gustav Carus, Technische Universität Dresden, Dresden, Deutschland

5Technische Universität Dresden, Faculty of Biology, Technische Universität

Dresden, Dresden, Deutschland

6National Center for Tumor Diseases (NCT), Partner Site Dresden, Dresden,

Deutschland

7Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie,

Universitätsklinikum C. G. Carus Dresden, Dresden, Deutschland

8Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde,

Universitätsklinikum C. G. Carus Dresden, Dresden, Deutschland

9Institut für Pathologie, Universitätsklinikum C. G. Carus Dresden, Dresden,

Deutschland

10Department of Radiotherapy and Radiation Oncology, Faculty of Medicine

and University Hospital Carl Gustav Carus, TUD, Dresden, Deutschland

11Klinik und Poliklinik für Viszeral-, Thorax- und Gefaßchirurgie,

Universitätsklinikum C. G. Carus Dresden, Dresden, Deutschland

Background: Previous data show that organoids can closely recapitulate

the characteristics of the tumor origin. Our aim is to establish organoids

derived from head and neck squamous cell carcinoma (HNSCC) patient

samples in order to investigate potential radiosensitizers for individual-

ized radiation oncology.

Methods: Organoids were established from fresh patient tumor and

normal tissue material according to Driehuis et al. 2020 (Driehuis et al.

2020, Nature Protocols) and characterized by histological staining and

DNA TSO500 panel and RNA sequencing. With six tumor lines, we per-

formed a drug screening using presto blue viability assay, where we tested

22potential radiosensitizing drugs aer 4 Gy irradiation. Methods for val-

idation of the screening results were established.

Result: Long-term culturing was possible in 24 out of 92 received spec-

imens (tumor/normal). Our established tumor organoids recapitulate a

squamous cell carcinoma phenotype in H&E staining and show typical

tumor mutations in genes like tp53, PIK3CA, EGFR and more. In the

drug screen, especially ATM- and EGFR-inhibitors showed a radiosen-

sitizing eect. To validate the potential hits, an organoid formation assay

was established, which enables investigation of clonogenic survival aer a

combined treatment with irradiation and drug application. A radiosensi-

tizing eect can be conrmed aer treatment with AZD0156, Afatinib or

Alpelisib in three organoid lines using this assay so far. AZD0156 shows

the greatest eect. Furthermore, gH2AX staining was established for irra-

diated organoids and is used for the validation of the screening results.

Discussion and Conclusion: Establishment of HNSCC organoids was

successful using our workow. ese 3D models can be used to screen for

potential radiosensitizers. For validation, we established an organoid for-

mation assay to determine the clonogenic survival as an important end-

point in radiobiology. Further investigations to compare organoids and

their corresponding tumor tissue are planned.

Disclosure Statement: e authors declare no conict of interest.

769

Stereotactic ultrahypofractionated MR-guided radiation

therapy for localized prostate cancer – rst results of the

prospective, multicenter SMILE trial

Stefan Körber1,2; Christoph Fink1; Jonas Ristau1,3; Carolin Buchele1;

Sebastian Klüter1; Jakob Liermann1; Philipp Hoegen1; Elisabetta Sandrini1;

Adriane Lentz-Hommertgen1; Lukas Baumann4; Nicolaus Andratschke5;

Michael Baumgartl5; Matthias Guckenberger5; Minglun LI6;

Michael Reiner6; Stefanie Corradini6; Claus Belka6; Juliane Hörner-Rieber1;

Jürgen Peter Debus1

1Klinik für Radioonkologie, Uniklinikum Heidelberg, Heidelberg, Deutschland

2Klinik für Strahlentherapie, Krankenhaus Barmherzige Brüder Regensburg,

Regensburg, Deutschland

3Klinik für Strahlentherapie, Maria Hilf Krankenhaus Mönchengladbach,

Mönchengladbach, Deutschland

4Institut für Medizinische Biometrie, Universität Heidelberg, Heidelberg,

Deutschland

5Klinik für Radioonkologie, Universitätsspital Zürich, Zürich, Schweiz

6Klinik für Radioonkologie, LMU Universitätsklinikum München, München,

Deutschland

Background: MR-guided radiation therapy (MRgRT) is a promising tool

for precise, adaptive and personalized irradiation. For the SMILE trial,

this modern technique was used for men with treatment-naïve prostate

cancer undergoing stereotactic body radiation therapy. Here we report on

the 3-months toxicity and patient-reported outcomes of the prospective,

multicenter phase II trial.

Methods: In total, 69 patients with localized prostate cancer were included

and underwent daily online-adaptive MRgRT across three European

university hospitals. Patients received no invasive procedures before or

during irradiation. e prescribed dose was 37.5 Gy in 5 fractions, with

an optional simultaneous boost of 40 Gy to the dominant intraprostatic

lesion. Toxicity data was dened according to CTCAE v. 5.0 and RTOG

and EORTC QLQ-C30 and PR25 scores were assessed upon radiother-

apy completion and at 6 and 12 weeks post-radiotherapy and compared

to baseline symptoms. Moreover, dose parameters were compared before

and aer online plane adaptation.

Result: We observed no grade 3+ toxicity according to CTCAE or RTOG

at the 12-week follow-up visit. Most frequent side eects were nocturia

and stool frequency. ere were no meaningful changes in the global

health status nor in relevant subscores. In a subgroup analysis of 32 men,

an adapted radiation plan was delivered in 95% of fractions. By daily

online adaptation, the mean planning target volume (PTV) coverage was

increased by 4.5%. Moreover, adaptation resulted in improved sparing of

organs at risk like the urethra.

Discussion: Daily online-adaptive MRgRT for treatment-naïve men with

localized prostate cancer led to favorable overall rates of acute GU and GI

toxicity. Most symptoms resolved within the initial 12 weeks of follow-up.

Conclusion: Initial ndings from the multicenter SMILE trial demon-

strated promising results regarding dose distribution, toxicity proles and

quality of life. However, an extended follow-up period is required to col-

lect long-term toxicity rates and oncological outcome parameters.

Disclosure Statement: e authors declare the following: is study was

funded by ViewRay. e industry sponsor had no role in the study design, data

collection, data analysis, interpretation, or the decision to publish the ndings. e

content of this article reects the independent views and research of the authors.

Andratschke, Corradini, Hörner-Rieber report honoraria from ViewRay.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 197

Rehabilitation, Sports Medicine, and

Long-term Burden in Cancer Survivors

Characteristics of exercise programs for cancer patients

in Europe and neighbouring countries: A comprehensive

overview and analysis

Annelie Voland1; Anna Campbell2; Joachim Wiskemann1

1AG Onkologische Sport- und Bewegungstherapie, Abteilung Medizinische

Onkologie, Nationales Centrum für Tumorerkrankungen (NCT) und

Universitätsklinikum Heidelberg, Heidelberg, Deutschland

2School of Applied Sciences, Edinburgh Napier University, Edinburgh, Scotland,

United Kingdom

Background: ere is strong evidence on the positive eects of physical

activity interventions in cancer patients. However, knowledge transfer

into practice and the implementation of cancer-specic exercise programs

are fragmentary and complex.

Objective: e aim of this study was to analyze existing cancer-specic

exercise programs in the European Union, United Kingdom and neigh-

bouring countries.

Methods: Data were systematically collected within a cross-sectional

quantitative survey based on the RE-AIM framework.

Results: We analysed 82 exercise programs from 16 dierent countries,

from which 33% were located in community-based settings and 31% in

hospital clinics. Most programs employed 1-5 employee within 1-2 pro-

gram locations, serving 50-150 patients per year. Up to 70% of surveyed

exercise programs collaborated with oncologists or oncology nurses.

Programs were delivered by various exercise professionals with diverse

educational levels and qualications such as academic degrees (52%) or

specic educational certicates (45%). Established programs reported a

high need of collaborations with health care professionals, educational

courses for trainers and the integration of programs into cancer care

systems. Program funding and health care professional support were the

most frequent barriers for program implementation.

Conclusion: Our survey suggests that a successful implementation of

an exercise program in the cancer setting requires a close interaction

and collaboration between the cancer clinicians and exercise providers.

Furthermore, specialised education in exercise oncology is needed for all

participating professionals. Based on these nding we present an exem-

plary pathway of exercise care in oncology.

Disclosure Statement: e authors declare no conict of interest.

Can Argentine Tango Support Quality of Life and Physical

Activity in Cancer Survivors?

Shiao Li Oei1; Anja Thronicke1; Jessica Groß2; Thomas Rieser1,3;

Sarah Becker2; Patricia Grabowski4,5; Gerrit Grieb6; Harald Matthes1,3;

Friedemann Schad1,4

1Forschungsinstitut Havelhöhe, am Gemeinschaftskrankenhaus Havelhöhe,

Berlin, Deutschland

2Brustzentrum, Gemeinschaftskrankenhaus Havelhöhe, Berlin, Deutschland

3Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie,

Charité – Universitätsmedizin Berlin, Berlin, Deutschland

4Onkologisches Zentrum, Interdisziplinäre Onkologie und Palliativmedizin,

Gemeinschaftskrankenhaus Havelhöhe, Berlin, Deutschland

5Institut für Medizinische Immunologie, Charité – Universitätsmedizin Berlin,

Berlin, Deutschland

6Plastische Chirurgie und Handchirurgie, Gemeinschaftskrankenhaus

Havelhöhe, Berlin, Deutschland

Background: For cancer survivors, long-term health-related quality of life

(QoL) burdens are dicult to manage. A six-week Argentine Tango pro-

gram eectively improved QoL in breast cancer survivors, and the ques-

tion was whether this could be sustained over a 12-month period and how

this was related to physical activity.

Methods: Stage I-III breast cancer survivors with cancer-associated

fatigue were enrolled and 50 survivors received the Tango program and

were compared with a historical Control cohort (n= 108), who did not

participate in Tango. Using the European Organization for Research and

Treatment of Cancer Questionnaire C30 (EORTC-QLQ-C30) and the

German version of the Cancer Fatigue Scale (CFS-D) self-reported QoL

parameters were assessed and longitudinal changes and correlations were

evaluated. Adjusted multivariable linear regression analyses were per-

formed to analyze associations between QoL scales and physical activities.

Result: Among the 50 Tango participants, the improvement in physical

functioning was sustained at 6 months (p=0.01) and 12 months (p=0.02).

is was not the case for the Control group at 12 months. e physical

activity assessment showed that increased fatigue (p=0.0005) and pain

(p = 0.005) were associated with less sporting activities, but not with

dancing.

Discussion: Physical activity is known to support QoL, but especially can-

cer survivors with severe fatigue symptoms have inhibitions to engage in

physical activity. It was found that dancing activities did not interfere with

any of the QoL scales, so dancing may be a way to break this vicious circle

and motivate physical activity despite fatigue.

Conclusion: Argentine Tango may be an appropriate component of early

supportive and follow-up care programs, to promote physical activity and

QoL and ultimately to improve long-term clinical outcomes of cancer

survivors.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

VersKiK study on paediatric cancer survivorship: preliminary

results

Ekaterina Aleshchenko1; Pietro Trocchi1; Claudia Spix2; Hiltrud Merzenich2;

Thorsten Langer3; Christian Lüpkes4; Peter Ihle5; Jutta Küpper-Nybelen5;

Peter Kaatsch2; Iris Meier6; Dirk Horenkamp-Sonntag6; Patrik Dröge7;

Thomas Ruhnke7; Ursula Marschall8; Melanie Klein9; Katja Baust10;

Gabriele Calaminus10; Juliane Glogner10; Christian Apfelbacher11;

Enno Swart11

1Institute of Social Medicine and Health Systems Research, Faculty of Medicine,

Otto von Guericke University, Magdeburg, Deutschland

2German Childhood Cancer Registry, Division of Childhood Cancer

Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics,

University Medical Center of Johannes Gutenberg University Mainz, Mainz,

Deutschland

3University Hospital of Schleswig-Holstein, Campus Lübeck, Lübeck,

Deutschland

4OFFIS–Institute for Information Technology, Oldenburg, Deutschland

5PMV research group at the Department of Child and Adolescent Psychiatry,

Psychotherapy and Psychosomatics, University of Cologne, Köln, Deutschland

6Techniker Krankenkasse, Hamburg, Deutschland

7AOK Research Institute, Berlin, Deutschland

8BARMER, Wuppertal, Deutschland

9DAK-Gesundheit, Hamburg, Deutschland

10Department of Pediatric Hematology and Oncology, University Hospital Bonn,

Bonn, Deutschland

11Institute of Social Medicine and Health Systems Research, Faculty of Medicine,

Otto von Guericke University, Magdeburg, Deutschland

Cancer in childhood or adolescence and its treatment might cause a

range of late eects. e aim of the VersKiK-study is to provide evidence

about late eects, follow-up care and adherence to follow-up guidelines.

Additionally, we will study care needs of cancer survivors and their infor-

mal caregivers.

VersKiK has a mixed-methods design [1]. e quantitative part is a

non-interventional, retrospective observational cohort study of data from

the German Childhood Cancer Registry (GCCR) linked with insurance

claims data. To study adherence, intended treatment data for selected

diagnoses will be added. e qualitative part combines participant obser-

vation, narrative interviews and focus groups.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts198

We will investigate late eects and utilization of medical services for about

27.000 GCCR patients registered from 1991 and survived until 1.1.2017.

Adherence to follow-up guidelines will be studied in a group of approxi-

mately 8.000 survivors with selected diagnoses.

To explore needs and experiences during follow-up, we conducted 19

unstructured observations of follow-up appointments and 36 volunteer

interviews. Combining them, we described “survivorship pathways” to

discuss in focus groups with about 50 healthcare providers.

e growing group of survivors aer cancer in childhood or adolescence

is associated with an increasing demand for long-term medical and psy-

chosocial support. e study design provides comprehensive evidence

about late eects of childhood cancer and generates suggestions for fol-

low-up care organisation improvement.

Reference:

1 Aleshchenko E, Swart E, Spix C, et al. Long-term care, care needs and

wellbeing of individuals aer cancer in childhood or adolescence (VersKiK):

study protocol of a large scale multi-methods non-interventional study. BMC

Health Services Research 2022;22(1):1176. doi:10.1186/s12913-022-08549-3

[published Online First: 20 September 2022].

Disclosure Statement: e authors declare no conict of interest.

212

Metastatic breast cancer patients’ perspectives on exercise – A

European mixed-methods study

Johanna Depenbusch1,2; Maike G Sweegers3,4; Neil Aaronson4;

Yvonne Wengström5; Malin Backman5; Nadira Gunasekara6;

Dorothea Clauss6; Melanie Schranz7; Britta Büchler7;

Juan Ignacio Arrarás8; Mireia Pelaez Puente9,10; Milena Lachowicz11;

Anne May12; Martijn M Stuiver3,4; Karen Steindorf1,2

1Division of Physical Activity, Prevention and Cancer, German Cancer Research

Center (DKFZ) Heidelberg, Heidelberg, Deutschland

2National Center for Tumor Diseases (NCT), NCT Heidelberg, a partnership

between DKFZ and University Medical Center Heidelberg,

Heidelberg, Deutschland

3Center for Quality of Life, Netherlands Cancer Institute/Antoni van

Leeuwenhoek Hospital, Amsterdam, Niederlande

4Department of Psychosocial Research and Epidemiology, Netherlands Cancer

Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, Niederlande

5Division of Nursing, Department of Neurobiology, Care Sciences, and Society,

Karolinska Institute, Stockholm, Schweden

6Department for Molecular and Cellular Sports Medicine, German Sport

University Cologne, Cologne, Deutschland

7Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI),

University Medical Center of the Johannes Gutenberg University Mainz,

Mainz, Deutschland

8Oncology Departments, Complejo Hospitalario de Navarra, Pamplona, Spanien

9Onkologikoa, San Sebastian, Spanien

10Faculty of Health Sciences, Universidad Europea del Atlántico,

Santander, Spanien

11Department of Oncology and Radiotherapy, Medical University of Gdańsk,

Gdansk, Polen

12Julius Center for Health Sciences and Primary Care, University Medical Center

Utrecht, Utrecht, Niederlande

Background: Exercise is a promising supportive care strategy for patients

with metastatic breast cancer (mBC), but research on the patients’ per-

spective is limited. e current mixed-methods study aimed to investigate

mBC patients’ views on exercise programs.

Methods: Patients with mBC from ve European countries (DE, ES,

NL, PL, SE) were invited to a semi-structured focus group (N = 44) or

a cross-sectional online survey study (N = 420) assessing attitudes and

knowledge towards exercise, physical activity levels, and exercise barri-

ers, facilitators, and preferences. Focus group discussions were audio- or

videotaped, transcribed verbatim, and translated into English. Relevant

statements were thematically coded with an iterative coding framework.

Survey data was analyzed with descriptive statistics.

Result: e study participants expressed positive attitudes and high

exercise intentions. While about half of the mBC patients reported to

know how much exercise they needed, only 8% actually knew current

exercise guidelines. is was also reected in low levels of higher-

intensity aerobic activities and resistance exercise. e main cited exer-

cise barriers were ‘no access to exercise programs for cancer patients’

(27%) and ‘feeling too weak’ (23%) or ‘too tired’ (23%). Focus group

discussions revealed that such physical barriers also led to insecurities.

Patients thus wished for individual tailoring of exercise and professional

supervision. Other facilitators were ‘previous positive physical (72%) or

emotional (68%) exercise experiences’ (survey) and social interaction in

group training (focus groups).

Discussion: Despite positive attitudes, physical restrictions and insecuri-

ties hinder some patients with mBC from exercise engagement. To help

patients’ overcome such barriers, exercise programs should be adjusted to

the individual needs and preferences and include professional supervision.

Conclusion: Individually tailored and supervised exercise programs

might help to improve exercise participation in patients with mBC.

Disclosure Statement: e authors declare no conict of interest.

425

Functional Fitness in Cancer Patients and Survivors

Frieder Krause1; Soe Nieland2; Katharina Graf1; Elke Jäger3; Lutz Vogt2

1Krankenhaus Nordwest, Klinik für Onkologie und Hämatologie, Institut für

onkologische Sport- und Bewegungstherapie, Frankfurt am Main, Deutschland

2Goethe-Universität Frankfurt am Main, Institut für Sportwissenschaften,

Abteilung Sportmedizin, Frankfurt am Main, Deutschland

3Krankenhaus Nordwest, Klinik für Onkologie und Hämatologie, Frankfurt am

Main, Deutschland

Background: Cancer patients commonly show a loss in quality of life and

functional capacities. e ECOG status is used to determine functional

status, but there is a lack of objective measures to determine functional

tness. is study evaluated the functional status of cancer patients using

the Senior-Fitness-Test (SFT) [1].

Methods: Patients during or aer anti-cancer treatment were recruited for

this study. Using the SFT, functional tness was assessed by a trained exer-

cise scientist. ECOG status was extracted from current medical records or

determined by a senior researcher using ocial rating descriptions [2].

For each SFT item, individual results were assigned to an age referring to

normative values [3]. Fitness age (FA) for each participant was dened as

the mean age from all seven items.

Results: A total of n=30 subjects (f=15, 61.6±12.1y, 16 during & 14 aer

therapy) participated in this study. FA diered signicantly from bio-

logical age (+8.59 years, 95%-CI: 3.65-13.5, p<.001) with no dierences

between therapy stages. Patients dened as limited in their functional sta-

tus (ECOG 1&2) showed no signicant dierence between FA and biolog-

ical age compared to patients with ECOG stage 0 (p=.346).

Discussion: Our results show that the SFT is feasible to assess the func-

tional status in cancer patients and survivors. Our sample showed an aver-

age functional tness comparable to healthy subjects almost nine years

older. However, these functional decits were not reected by the ECOG

status, nor diered between patients during or survivors aer therapy.

Conclusion: Our results underline the need for objective measures to

assess the functional status for tailored exercise programs to address long-

term functional limitations in cancer patients and survivors.

References:

1 Rikli RE, Jones CJ. Journal of Aging and Physical Activity 1999; 7(2): 129–61.

2 Azam F, Latif MF, Farooq A, et al. Case Rep Oncol 2020; 12(3): 728–36.

3 Rikli RE, Jones CJ. Journal of Aging and Physical Activity 1999; 7(2): 162–81.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 199

536

Eects of exercise on fatigue and quality of life in metastatic

breast cancer patients: The randomized controlled

PREFERABLE-EFFECT study

Johanna Depenbusch1,2; Anouk E. Hiensch3; Martina Schmidt1,2;

Evelyn M. Monninkhof3; Mireia Pelaez Puente4,5; Dorothea Clauss6;

Philipp Zimmer6,7; Jon Belloso5; Mark Trevaskis8; Helene Rundqvist9;

Joachim Wiskemann2,10; Jana Müller2,10; Carlo Fremd2,10; Renske Altena11;

Joanna Kufel-Grabowska12; Rhode M. Bijlsma3; Lobke van Leeuwen-

Snoeks13; Daan Ten Bokkel-Huinink14; Gabe Sonke15; Bruce Mann16;

Prue Francis17; Gary Richardson18; Wolfram Malter19; Isabel Manuela

Álvarez López20; Elsken van der Wall3; Neil Aaronson15; Elżbieta Senkus12;

Ander Urruticoechea5; Eva Zopf8,21; Wilhelm Bloch6; Martijn M Stuiver15;

Yvonne Wengström9; Anne May3*; Karen Steindorf1,2*

*geteilte Letztautorenschaft

1German Cancer Research Center (DKFZ) Heidelberg, Heidelberg, Deutschland,

2National Center for Tumor Diseases (NCT), NCT Heidelberg, a partnership

between DKFZ and University Medical Center Heidelberg, Heidelberg,

Deutschland

3University Medical Center Utrecht, Utrecht, Niederlande

4Universidad Europea del Atlántico, Santander, Spanien

5Onkologikoa, San Sebastian, Spanien

6German Sport University Cologne (DSHS), Cologne, Deutschland

7TU Dortmund University, Dortmund, Deutschland

8Australian Catholic University, Melbourne, Australien

9Karolinska Institute, Stockholm, Schweden

10Heidelberg University Hospital, Heidelberg, Deutschland

11Karolinska Comprehensive Cancer Center, Stockholm, Schweden

12Medical University of Gdańsk, Gdansk, Polen

13Diakonessenhuis, Utrecht, Niederlande

14Alexander Monro Hospital, Bilthoven, Niederlande

15Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital,

Amsterdam, Niederlande

16Royal Melbourne Hospital, Melbourne, Australien

17Peter MacCallum Cancer Center, Melbourne, Australien

18Cabrini Hospital, Malvern, Victoria, Australien

19Women’s Hospital, University Hospital Cologne, Cologne, Deutschland,

20Biodonostia, San Sebastian, Spanien

21Cabrini Health, Melbourne, Australien

Background: Exercise is an eective supportive care strategy for patients

with breast cancer in the curative setting, but evidence in patients with

metastatic breast cancer (mBC) is lacking. e PREFERABLE-EFFECT

study (NCT04120298) investigated the eects of exercise in patients with

mBC on fatigue, quality of life (QoL), and other cancer- and treatment-

related side eects.

Methods: e randomized controlled trial included patients with mBC

(ECOG performance status ≤ 2) from ve European countries (DE, ES,

NL, PL, SE) and Australia. Participants were randomly assigned to usual

care or a 9-month individualized, structured exercise program consist-

ing of 2x/week supervised aerobic, resistance, and balance training. e

primary outcomes, physical fatigue (EORTC QLQ-FA12 subscale) and

QoL (EORTC QLQ-C30 summary score) were assessed at baseline, 3, 6,

and 9 months. Changes from baseline to 3, 6 (primary endpoint), and 9

months were compared between groups using mixed models for repeated

measures. A signicant improvement of either or both primary outcomes

(Bonferroni-Holm adjusted) was considered as successful.

Result: A total of 357 patients with mBC were randomized (exercise=178,

usual care=179). Patients were on average 55.4 years old (SD=11.1) and

74.8% received 1st or 2nd line treatment. e exercise program resulted in

signicant positive eects on both primary outcomes. Physical fatigue

was lower (mean dierence: -5.3 [95% CI: -10.0; -0.6], p=.027, ES=0.22)

and QoL higher (+4.8 [2.2; 7.4], p=.0003, ES=0.33) in the exercise group

compared to usual care at the 6-month primary endpoint, as well as at 3

and 9 months. e 6-month analyses further yielded benecial exercise

eects on QoL subscales such as social functioning, pain, and dyspnea.

Two SAEs occurred (wrist and sacral stress fracture), neither related to

bone metastases.

Discussion: Our large multinational study demonstrated the ecacy of

supervised exercise during palliative treatment on mBC patients’ fatigue

and QoL.

Conclusion: Supervised exercise should be recommended during treat-

ment of mBC.

Disclosure Statement: e authors declare the following: Prof Prue Francis:

Honorarium from Eli Lilly (lecture on pregnancy/fertility in breast cancer)

564

Eects of the oncology rehab aftercare website Onko-Vital on

physical activity and relaxation behavior three and six months

after rehab discharge

Heike Kähnert1; Birgit Leibbrand2

1IfR, Norderney, Abt. Bad Salzuen, Bad Salzuen, Deutschland

2Salzetalklinik, Bad Salzuen, Deutschland

Background: A healthy lifestyle including physical activity and relaxation

behavior plays a major role in the rehabilitation of cancer patients. e

rehab aercare website Onko-Vital is designed to help cancer patients to

realize aercare goals regarding a healthy lifestyle in the long term. is

study examines the eectiveness of Onko-Vital (OV) in implementing

aercare goals (AG), sports activity (SA), and relaxation behavior (RB) up

to 6 months aer discharge.

Methods: Cancer patients (n=242) who underwent a rehab were ran-

domly assigned to the control (CG) or intervention group (IG). ey were

interviewed using self-report questionnaires at the beginning (t1), 3 (t3)

and 6 months (t4) aer discharge. While the CG received the usual care,

the IG additionally received the OV-intervention. Chi-square tests and

ANCOVA were applied to investigate dierences between CG and IG

regarding the AG, SA, and RB.

Result: Two commonly mentioned AG were: AG1: becoming more active

in sports (95%) and AG2: learning to cope with stress (78%). At t4, goal

achievement of more than 50% was signicantly higher in IG than in CG

(AG1: IG=58%; KG= 38%, p≤0.01, ɸ=0.207 / AG2: IG=57%; CG=33%,

p≤0.01, ɸ=0.240).

At t1, approximately 39% of both groups reported sports activity. At t3 and

t4, the proportion increased in both groups, but was signicantly higher

in the IG than in the CG in each case (t3: IG=78%, CG=61%, p≤0.01,

ɸ=0.180 / t4: IG=75%, CG=61%; p≤0.05, ɸ=0.151).

At t1, 17% practiced relaxation techniques in the total sample. e per-

centage increased in both groups, but was signicantly higher in the IG

than in the CG at t3 and t4 (t3: IG=45%, CG=32%, p≤0.05, ɸ=0.128 / t4:

IG=48%, CG=25%; p≤0.01, ɸ=0.240).

No group dierence in the average duration (min/week) of SA and RB can

be demonstrated at any measurement time point.

Conclusion: is study demonstrates that the Onko Vital website is a

useful intervention to improve goal implementation, sports activity and

relaxation behavior in cancer patients up to 6 months aer discharge.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts200

589

Pregnancies and childbirth following treatment with

BrECADD or eBEACOPP for advanced-stage Hodgkin

Lymphomain the GHSG randomized phase III HD21 trial

Justin Ferdinandus1,2; Gundolf Schneider1,2; Alden Moccia3,4;

Richard Greil5,6; Andrea Kerkho7; Sebastian Scholl8; Yon-Dschun Ko9;

Max Topp10; Joachim Beck11; Vladan Vucinic12; Wolfram Jung13;

Roland Schroers14; Andreas Rank15; Carla Damaschin1,2;

Anne Sophie Jacob1,2; Michael Fuchs1,2; Peter Borchmann1,2;

Karolin Behringer1,2

1Klinik I für Innere Medizin und CIO Aachen Bonn Köln Düsseldorf, Uniklinik

Köln, Köln, Deutschland

2Deutsche Hodgkin Studiengruppe (GHSG), Köln, Deutschland

3Oncology Institute of Southern Switzerland, Bellinzona, Schweiz

4Swiss Group for Clinical Cancer Research, Bern, Schweiz

5Universitätsklinik für Innere Medizin III, Uniklinikum Salzburg,

Salzburg, Österreich

6Arbeitsgemeinschaft medikamentöser Tumortherapie (AGMT),

Salzburg, Österreich

7Medizinische Klinik A, Universitätsklinikum Münster, Münster, Deutschland

8Klinik für Innere Medizin II, Universitätsklinikum Jena, Jena, Deutschland

9Hämatologie, Internistische Onkologie, Johanniter-Krankenhaus Bonn,

Bonn, Deutschland

10Medizinische Klinik II, Universitätsklinikum Würzburg, Würzburg, Deutschland

11III. Medizinische Klinik, Universitätsmedizin Mainz, Mainz, Deutschland

12Klinik und Poliklinik für Hämatologie, Zelltherapie, Hämostaseologie und

Infektiologie, Universitätsklinikum Leipzig, Leipzig, Deutschland

13Klinik für Hämatologie und Medizinische Onkologie, Universitätsmedizin

Göttingen, Göttingen, Deutschland

14Hämatologie, Onkologie, Stammzell- und Immuntherapie,

Universitätsklinikum Knappschaftskrankenhaus Bochum, Bochum, Deutschland

15II. Medizinische Klinik, Universitätsklinikum Augsburg, Augsburg, Deutschland

Background: e phase III GHSG-HD21 trial compares BrECADD to

eBEACOPP in adult patients with newly diagnosed advanced-stage clas-

sical Hodgkin lymphoma (AS-cHL). Fertility is a major concern for the

mostly young patients with AS-HL. erefore, we analyzed pregnancies

and childbirth rates reported in HD21.

Methods: 1500 patients with AS-cHL aged 18-60 yrs were randomized to

PET2-guided 4-6 cycles of either eBEACOPP or BrECADD. Pregnancies

among patients or their partners were analyzed in female patients <40

yrs and male patients <50 yrs of the ITT cohort. Childbirth rates per

year were compared to population data for women between 18-40 yrs,

obtained from the German Federal Statistical Oce (Destatis). e trial

was registered at clinicaltrials.gov (NCT02661503).

Result: e nal cohort for this analysis comprised 1200 patients (496

female). 55.6% patients had cryopreservation prior to therapy. Aer a

median FU of 40 months, 126 pregnancies were reported in 97 (9.1%)

patients: 38 (7.2%) and 53 (9.8%) in eBEACOPP and BrECADD arm,

respectively. Compared to eBEACOPP, pregnancy rates following

BrECADD were higher in males (2.5% vs 5.7%) and females (11.8% vs

13.2%). Only 8.2% of patients with reported pregnancy made use of cry-

opreservation. 82.2% of all pregnancies resulted in childbirth and 17.9%

ended early. In women between 18 and 40 yrs, the childbirth rate per

year increased during the rst two years aer treatment (1st year: 0.6%;

2nd year: 4.4%) and numerically reached a higher rate compared to the

German reference population (6.5%) starting from the 3rd year (3rd year:

8.8%; 4th year: 8.0%; 5th year: 7.8%).

Discussion: We report high rates of pregnancies following chemotherapy

in the HD21 trial. Overall, childbirth rates in women aer the 2nd year of

FU are comparable to the German population. Compared to eBEACOPP,

pregnancy rates were twofold higher in partners of men who received

BrECADD and slightly higher in women.

Conclusion: Together with unparalleled primary cure rate achieved with

BrECADD, our data supports its use in young patients with a desire to

have children.

Disclosure Statement: e authors declare the following: Speaker fees from Roche

and Takeda Oncology.

655

Long-term cryostorage has no eect on vitality and motility

of spermatozoa – even in patients with limited semen

parameters

Simone Bier; Daniela Hanke; Michael Zitzmann; Verena Nordho;

Sabine Kliesch

Centre of Reproductive Medicine and Andrology, University Hospital of

Münster, Münster, Deutschland

Cryopreservation of human semen is mandatory to preserve a man’s fer-

tility before initiation of gonadotoxic therapy. In healthy men with nor-

mal semen parameters it has been shown that aer 10 years of storage,

the quality of samples is restricted. However, data regarding patients with

malignant diseases and/or oligozoospermia are lacking but required for

adequate counseling. Semen parameters are oen reduced in men with

malignant diseases, which is assumed to be a paraneoplastic eect.

We have cryopreserved human semen samples of 6,022 patients before

the start of gonadotoxic therapy (data from years 2001- 2019). Of these

patients, 292 donated their cryopreserved samples for research aer

termination of their depot. We evaluated semen motility and vitality of

the freeze-thawed spermatozoa aer various duration of their storage

time and compared them to the initial values collected on the day of

cryopreservation.

Aer subdividing the samples into 3 groups according to duration-time

of storage (cryostorage time ≤ 5 years, n=49, between > 5 and ≤ 14 years,

n=213 and of more than 14 years, n=31) there were no signicant dif-

ferences of baseline values regarding sperm count, sperm concentration,

motility or vitality. Also none of the post-thawing values (motility or vital-

ity) were dierent (ANOVA for repeated measurements). Furthermore,

a regression analysis could not show a signicant eect of storage time

on motility or vitality (p=0.53 and p=0.64). Also in patients with oligo-

zoospermia, the regression analysis did not show a signicant eect of

the storage time on motility (p=0.99). However, baseline concentration as

well as motility were positively and signicantly related to these param-

eters post-thawing, irrespective of the time period the semen was stored

(p=0.02 and p=0.01).

Cryopreserved semen samples are not impaired due to long storage times.

We could show that long-term cryostorage of human spermatozoa is a safe

method and can reliably preserve fertility even in patients with restricted

semen parameters at the time point of cryopreservation.

Disclosure Statement: e authors declare no conict of interest.

665

Development of a multimodal therapy concept for the

rehabilitation of people with uveal melanoma

Oliver Kolbe; Lars Choritz; Kunert Kathleen S

REGIOMED Rehaklinik Masserberg, Abteilung Ophthalmologische

Rehabilitation, Masserberg, Deutschland

Background: Each year, approximately 1800 people are treated in acute

care for choroidal melanoma disease in Germany. e disease leads to

severe social and occupational barriers.

Methods: e specic occupational and social problems were analysed

by means of qualitative interviews with patients and experts at the only

German clinic for ophthalmology rehabilitation (REGIOMED Rehaklinik

Masserberg) and therapy options were developed.

Result: People with choroidal melanoma suer from the psychological

consequences of the cancer and the (functional) monocularity associated

with the therapy. ey have problems with balance and orientation, asso-

ciated posture problems due to e.g. compensatory head inclination and a

greater fear of falling. Occupational problems result from the limitations

of the visual eld, the specic demands of the occupation on spatial vision

and legal framework conditions (e.g. driving ability).

Discussion: Based on the identied problems, multimodal therapy options

were developed, such as a specic fall prevention training, a sports and

functional training to improve spatial perception or specic psychological

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 201

discussion groups. In combination with a general occupational orienta-

tion of the rehabilitation, a separate rehabilitation concept was developed.

e submission to the Deutsche Rentenversicherung (German pension

insurance) led to an approval for the rst ophthalmological follow-up

treatment (Anschlussheilbehandlung) in Germany.

Conclusion: People with uveal melanoma can start a rehabilitation with

a legal claim within the framework of a follow-up treatment that is geared

to their specic needs. A quantitative analysis of the eect of this reha-

bilitation on the quality of life related to the visual impairments relevant

to everyday life (based on the National Eye Institute Visual Function

Questionnaire, NEI-VFQ) is currently being performed.

Disclosure Statement: e authors declare the following: Beschäigungsverhältnis

an Klinik an der Konzept umgesetzt ist.

681

Information needs of cancer long-term survivors

Winja Weber1; Eva Baumann2; Evelyn Kludt1; Susanne Weg-Remers1

1Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Deutschland

2Institut für Journalistik und Kommunikationsforschung, Hannover,

Deutschland

Background: In Germany, about 5 million people are cancer survivors –

over half of them received their initial diagnosis more than ve years ago.

ese long-term survivors and their relatives are oen confronted with late

and/or long-term eects of cancer or cancer therapy. In order to support

them with appropriate information, further knowledge about this target

group and their needs for information is important.

Methods: erefore, we analyzed N = 33,944 inquiries of cancer patients

or their relatives to a large provider of cancer information in Germany via

telephone or e-mail between 2019 and 2023.

Result: About a quarter of the inquiries were from individuals whose ini-

tial diagnosis was more than ve years ago (n = 9,075). e long-term can-

cer survivors were on average 63.6 years old and 66.3% female. In 77.2%,

the patients themselves inquired, in 22.8% their relatives did. e main

disease situation of the patients was relapse (36.8%), followed by the phase

aer initial treatment (29.6%), and a palliative situation (18.1%). e

dominating tumor regions were breast (42.7%) and male genital organs

(e.g. prostate, 22%). Overall, the information need was very high, in par-

ticular, for information on treatment (64.4% of all requests), living with

cancer (56.7%), contact details of providers (38.7%), and psychological

aspects (32.9%). Information needs of long-term survivors didn’t dier

signicantly from the need of people whose rst diagnosis was one to ve

years ago. However, dierences become apparent, when the patients had

metastases: ose patients mainly requested information on treatment

topics, while the information needs of patients without metastases and

their relatives primarily revolved around living with cancer.

Discussion/Conclusion: Long-term cancer survivors have a high and

wide-ranging need for information. In order to provide this heteroge-

neous target group with tailored information, characteristics such as their

disease situation in particular must be taken into account.

Disclosure Statement: e authors declare no conict of interest.

707

Expansion of urological therapy options in oncological

rehabilitation through digital forms of training

Ivonne Rudolph; Heiko Primus; Bettine Bilsing

Rehabilitationsklinik Bad Salzelmen, Schönebeck, Deutschland

Background: Visualizing and training body awareness are important

therapeutic components of sphincter and pelvic oor training to improve

continence status. In order to achieve this primary rehabilitation goal for

prostate patients in the best possible way, the Bad Salzelmen rehabilitation

clinic has introduced digital pelvic oor training since June 2023 in addi-

tion to the usual care program. is specic form of digital training uses a

digital sensor tube to measure the activity of the pelvic oor when you are

dressed. With this digital form of training, the rehabilitant should be able

to train an adequate control of the sphincter or pelvic oor.

Methods: A pilot study will start in September 2023 with the primary

study goal of evaluating the continence status in relation to expanding

the therapy spectrum through the digital form of training. e control

group receives the usual care program and the intervention group receives

a digital training session in addition to daily pelvic oor exercises. In

both groups, pelvic oor activity and the degree of urinary incontinence

(ICIQ) are determined at the beginning and at the end of the rehabilita-

tion. Furthermore, a 24-hour pad weight test is carried out at the begin-

ning and at the end of the rehabilitation. In addition, a follow-up aer 3

months is planned.

Result: e rst results are expected in spring 2024.

Conclusion: Digital therapeutic modules represent a promising addition

to previous usual care programs. e transfer of learned everyday exer-

cises can be supported in this way.

Indication of source: Baumann, F.T., Zopf, E.M. & Bloch, W. Clinical exercise

interventions in prostate cancer patients—a systematic review of randomized

controlled trials. Support Care Cancer 20, 221–233 (2012).

Disclosure Statement: e authors declare no conict of interest.

807

Similar EPOC patterns, but slower V

.O2 recovery kinetics

in cancer patients receiving immunotherapy compared to

survivors and heathy controls

Damir Zubac; Timo Niels; Freerk T. Baumann

Uniklinik Köln, Innere Medizin I, Köln, Deutschland

Introduction: Excess post-exercise O2 consumption (EPOC), a measure

of metabolic control in exercising muscles, is associated with O2 and ATP/

CP resynthesis aer aerobic exercise cessation. EPOC is well-studied in

healthy individuals, but there’s a scarcity of data in clinical populations,

including cancer patients. We investigated EPOC kinetics aer moder-

ate-intensity cycling to enhance our understanding of metabolic regula-

tion in the active musculature following aerobic exercise cessation.

Methods: Twenty-one adults participated, grouped into cancer patients

undergoing immunotherapy (n=7, age 56±13), survivors (n=6, age

45±16), and healthy controls (n=8, age 45±13), cleared for two experi-

mental sessions. Initial data collection included body composition, medi-

cal history, and previous physical activity records. Participants underwent

a ramp V

.O2 peak test, followed by three step-transition tests progress-

ing to a 90% V

.O2 uptake of the gas exchange threshold (GET). is was

followed by a 30-minute GET cycling session, with simultaneous meta-

bolic and cardiovascular data collection. A 10-minute EPOC recording

followed test cessation.

Results: Peak V

.O2 and power outputs were higher in healthy controls

than in survivors and immunotherapy patients (both by ~20% p < 0.05).

Aer moderate-intensity cycling, cancer patients showed slower τV

.O2-o

kinetics by ~10 seconds compared to the other two groups, with similar

EPOC values (~1050 mL·O2) in all three groups.

Conclusion Slower recovery rates observed among immunotherapy

patients, combined with lower V

.O2 peak uptake, indicate an impairment

of muscular aerobic metabolism, resulting in decreased ability to toler-

ate aerobic exercise. e conclusions apply only to this group and study

design. Future research should consider age dierences in exercise inter-

ventions for better cardiometabolic outcomes.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts202

809

Study of long-term survivorship of lymphoma patients –

amulticenter longitudinal study of return to work and

quality of life

Ruth Elisa Eyl-Armbruster1; Julia Wendler1,2; Ramona Böttinger2;

Simone Neumaier1; Antje Jensch1; Susanne Walz1; Markus Knott1,2;

Susanne Rössle3; Nicola Giesen4; Jessika Strentzsch5; Veronika Schindler6;

Hans-Georg Kopp3,4; Jochen Greiner3,6; Claudio Denzlinger3,5;

Gerald Illerhaus1,2,3

1Stuttgart Cancer Center – Tumorzentrum Eva Mayr-Stihl, Klinikum Stuttgart,

Stuttgart, Deutschland

2Clinic for Hematology, Oncology and Palliative Care, Klinikum Stuttgart,

Stuttgart, Deutschland

3Department of health care research, Onkologischer Schwerpunkt Stuttgart e.V.,

Stuttgart, Deutschland

4Department of Hematology, Oncology and Palliative Medicine, Robert Bosch

Hospital, Stuttgart, Deutschland

5Department of Hematology, Oncology and Palliative Care, Marienhospital

Stuttgart, Stuttgart, Deutschland

6Department of Internal Medicine, Diakonie Hospital Stuttgart, Stuttgart,

Deutschland

Background: Due to improving treatment options over the past decades,

lymphoma long-term survivors and their ability to participate in work

substantially gain in importance. However, only a few studies have iden-

tied inuencing factors for their return to work process so far. us, this

study aims to investigate the association between demographic, psychoso-

cial, work-specic, and motivational factors in addition to medical aspects

and lymphoma patients’ return to work.

Methods: is longitudinal, multicenter study is planned and conducted

by the Stuttgart Cancer Center and 3 other clinics of the Onkologischer

Schwerpunkt Stuttgart. Patients with Hodgkin’s lymphoma, Mantel cell

lymphoma, Follicular lymphoma, and Diuse large B-cell lymphoma aged

18-65 years who receive systemic chemotherapy either at initial diagnosis

(ID) or relapse are included in our study. Partly abbreviated standardized

and validated questionnaires (e.g. COPSOQ, UWES, EORTC QLQ-C30)

assess patients’ work and life situation at ID as well as 6 and 12 months

aer the end of therapy. ese parameters are correlated with clinical

data (disease stage, prognosis scores, and ECOG PS). Patient recruitment

started in May 2021 and is ongoing.

Result: So far 47 patients agreed to participate. 51% of patients were

female, symptom burden was generally low (81% ECOG PS 0), 70% were

married or in a permanent relationship and 31% were solely responsi-

ble for the total household income. At ID 66% of patients were working

full time, 21% part time and 6% were unemployed. At 6 months, 65%

of patients reported no change in their working situation and only 10%

ofpatients had reduced their weekly working hours. e average time of

return to work was 17 weeks. Surprisingly, rst analyses did not show any

correlation between patients’ prognosis on their future return to work

and their current work situation. However, patients who reported higher

levels of fatigue and depression were less optimistic about their return

to work.

Disclosure Statement: e authors declare no conict of interest.

812

Polarized and Threshold Training Intensity Distribution in

Cancer Survivors: A randomized controlled trial

Nikolai Bauer1; Justine Schneider1; Kathrin Schlüter1;

Joachim Wiskemann1; Friederike Rosenberger1,2

1Nationales Centrum für Tumorerkrankungen (NCT) Heidelberg, Heidelberg,

Deutschland

2Deutsche Hochschule für Prävention und Gesundheitsmanagement,

Saarbrücken, Deutschland

Background: Polarized training intensity distribution is eective to

improve the endurance capacity of athletes. However, there is a lack of

research regarding the eects of polarized training intensity distribution

on endurance capacity in breast and prostate cancer survivors.

Methods: 28 breast cancer and 27 prostate cancer survivors were random-

ized to a polarized (POL, n = 27, age 60±8 years, VO2peak 23 mL·min-1·kg-1) or

threshold training group (T, n = 28, age 59±10 years, VO2peak 23 mL·min-

1·kg-1) and completed two sessions per week on a cycle ergometer over 12

weeks. Exercise duration was adjusted so that energy expenditure was the

same in both groups. Cardiopulmonary exercise and verication tests were

performed to determine endurance capacity (VO2peak, peak power output

(PPO), ventilatory threshold (VT1) and lactate thresholds (LT1 and IAT)).

Result: POL and T signicantly (p<.001) improved their endurance

capacity in terms of VO2peak (0.09 and 0.12 L·min-1), PPO (27 and 17W),

power output at VT1 (11 and 13W), oxygen uptake at VT1 (0.09 and 0.11

L·min-1), power output at LT1 (7 and 12W) and power output at IAT (12 and

14W). No dierence was found between training groups, however, thresh-

old training required signicantly (p<.001) less time than polarized training

(59±1 min/week vs. 76±11 min/week). Analysis of energy expenditure over

the course of the intervention also revealed no dierences between groups

(POL: 170±43 kJ/session, T: 175±35 kJ/session, p=0.10).

Discussion: Polarized training intensity distribution and isocaloric

threshold training produced comparable eects on endurance capacity in

cancer survivors, with threshold training requiring signicantly less time

to produce these eects.

Conclusion: We conclude that breast and prostate cancer survivors can

perform both polarized and isocaloric threshold training and that both

types of training can lead to comparable eects on endurance capacity.

However, threshold training required less training time on average, thus

cancer survivors with limited time may prefer threshold training.

Disclosure Statement: e authors declare no conict of interest.

860

Muscle wasting and accompanying symptoms in the

SARCO-DETECT study

Lisa Jochem1; Lea Feline Kraack1; Friederike Hilpert1; Ilka Ratjen2;

Friederike Stölzel3; Thore Wul1; Anne Letsch3; Thorsten Schmidt3

1Christian Albrechts University, Kiel, Deutschland

2University Hospital Schleswig-Holstein (UKSH), Kiel, Deutschland

3University Cancer Center Schleswig-Holstein, Kiel, Deutschland

Background: Muscle wasting is a serious condition in cancer patients and

oen accompanied by reduced quality of life and fatigue, also associated

with a reduction of overall survival. e intention of SARCO-DETECT is

to examine interrelations between quality of life, fatigue previous physical

activity and skeletal muscle mass.

Methods: Overall, 109 cancer patients with various hematologic and

oncologic malignancies (63% male; mean age, 67y (SD±11.0)) at the

University Hospital Schleswig-Holstein were asked to ll in three ques-

tionnaires regarding quality of life (EORTC-QLQ C30), fatigue (FACIT-F)

and physical activity (BSA). Skeletal muscle index (SMI) was calculated

using computer tomography (CT) of muscle area around the third lum-

bar vertebrae. First calculations were performed, analyzing associations of

SMI and quality of life, fatigue and prior physical activity using multivari-

able-adjusted regression analysis.

Result: In this sample, 13% of the patients showed a reduced SMI. e

continuous SMI was not signicantly associated with overall quality of

life (ß=0.001, 95% condence interval (CI): 0.000-0.002, p=0.19), fatigue

(ß=0.004, 95% CI: -0.005-0.014, p=0.34) and prior physical activity in the

last 5 years (p=0.95).

Discussion: Unlike many other studies, in this very heterogenous cohort

of cancer patients no signicant associations between SMI, quality of

life, fatigue and prior physical activity could be found in the SARCO-

DETECT sample. Only few patients showed reduced SMI scores though,

thus impeding the nding of associations and underlining the need to

analyze more dened and larger patient subgroups.

Conclusion: In order to being able to detect associations described in the

literature, SARCO-DETECT will be pursued, focusing on patient sub-

groups with reduced SMIs.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 203

946

„Deutsches Kompetenzzentrum Leistungssport und Krebs“–

Professional and interdisciplinary care for competitive

athletes living with and beyond cancer

Nora Zoth1; Axel Heidenreich2; Roman Pster3; Peer Eysel4;

Wolfram Malter5; Sabine Vay6; Jan Werner6; Argiris Vassiliadis7;

Sina Michaelis1; Hans-Georg Predel7; Michael Hallek1; Freerk T. Baumann1

1University Hospital Cologne, Dept. of Internal Medicine I, Centre of Integrated

Oncology Cologne, Cologne, Deutschland

2University Hospital Cologne, Dept. of Urology, Uro-Onology, Root-Assisted and

Specialzed Urologic Surgery, Cologne, Deutschland

3University Hospital Cologne, Dept. of Internal Medicine III, Heart Centre,

Cologne, Deutschland

4University Hospital Cologne, Dept. of Orthopaedics and Trauma Surgery,

Cologne, Deutschland

5University Hospital Cologne, Dept. of Obstetrics and Gynecology, Women‘s

Clinic and Breast Center, Cologne, Deutschland

6University Hospital Cologne, Dept. of Neurology, Faculty of Medicine and

University Hospital Cologne, Cologne, Deutschland

7German Sport University Cologne, Institute for Cardiology and Sports

Medicine, Dept. of Preventive and Rehabilitative Sport Medicine and Exercise

Physiology, Cologne, Deutschland

Background: As a result of improved treatment options and associated

higher survival rates, professional athletes living with and beyond can-

cer are increasingly planning to return to competitive sport. Besides

sport-specic coaching, managing side eects of medical treatment is key

to being able to exercise during cancer treatment. Consequently, there is a

growing need for targeted collaboration between oncology, organ specic

specialists and sports science in the care of high-performance athletes.

Methods: e German Competence Centre for Competitive Sport and

Cancer provides support to high-performance athletes who suer from

cancer during their active career. e core tasks of the centre are counsel-

ling, treatment and care of the aected athletes and their relatives, but also

of the coaches and attending physicians.

Result: Following a comprehensive medical assessment of whether a

return to competitive sport is justiable, the aim is to ensure the fastest

possible and most individualised reintegration into competitive sport.

Training concepts that are individually tailored to the athlete, type of

sport, cancer and medical therapy are essential. ese demands can be

met by a specialist conference e.g. consisting of oncologists, physicians

and sport scientists.

Discussion: Despite convincing evidence and illustrations in relevant

guidelines that physical activity is safe and eective in the context of

cancer, there are no specic recommendations for training concepts in

high-performance athletes. In addition, there is no suitable infrastructure

that enables the bundling of expertise necessary for the care of aected

athletes.

Conclusion: e German Competence Centre for Competitive Sport and

Cancer will bridge the gap between medical and therapeutic professionals,

athletes and the athlete’s environment. e athlete receives the best pos-

sible care through the involvement of top physicians of whom some have

been top athletes themselves in the past, the reduction of medical side

eects, close cardiological screening and training relevant diagnostics.

Disclosure Statement: e authors declare no conict of interest.

Sarcoma

164

Clinical characteristics of sarcoma patients:a population-

based data analysis ona German clinical cancer registry

Jörg Andreas Müller1; Stefan Delank2; Alexander Zeh2; Ian Wittenberg3,4;

Daniel Medenwald4,5; Dirk Vordermark5

1Universitätsklinikum Halle (Saale), Department für Strahlenmedizin Univ.-Klinik

und Poliklinik für Strahlentherapie Halle (Saale), Deutschland

2Universitätsklinikum, Halle, Department für Orthopädie, Unfall- und

Wiederherstellungschirurgie Halle (Saale), Deutschland

3Klinische Krebsregister Sachsen-Anhalt gGmbH, Magdeburg, Deutschland

4Martin-Luther-Universität Halle-Wittenberg Medizinische Fakultät Institut

für Medizinische Epidemiologie, Biometrie und Informatik, Halle (Saale),

Deutschland

5Universitätsklinikum Halle (Saale), Department für Strahlenmedizin Univ.-Klinik

und Poliklinik für Strahlentherapie, Halle (Saale), Deutschland

Background: Sarcomas are a heterogenous group of malignant neoplasms

with a wide range of histological types and occur in almost any anatomic

side.

Methods: e German clinical cancer register of Saxony-Anhalt was

assessed. Sarcoma cases of all clinical or pathological T-stages (T1a-T4c),

all N-stages (N0-3) and M-stages (0-1b) corresponding to the UICC

stages I to IVB were considered. In our analyses, n=787 cases diagnosed

between 2005 and 2022 were included. Further, we assessed the associa-

tion of cancer-related parameters with mortality, hazard ratios (HR) from

Cox proportional hazards models were computed.

Result: e majority of sarcoma patients was diagnosed with

Leiomyosarcoma (12%), Liposarcoma (11%), Angiosarcoma (5.3%) and

Myxobrosarcoma (2.7%). In our univariate regression models, tumors

localized in more than one location, head, face and neck region as well

as pelvic and lower extremity sarcoma were associated with increased

mortality risk (more than one location: HR: 7.10, 95% CI 2.20-22.9; head,

face and neck: HR: 1.35, 95% CI 0.89-2.06; pelvis: HR: 1.27, 95% CI 0.86-

1.89; lower extremity: HR: 1.44, 95% CI 1.05-1.96). Higher histological

grades, UICC-grades and TNM-stages were related to a higher mortality

risk. Patients diagnosed with bromyxoid sarcoma, rhabdomyosarcoma

and hemangiosarcoma were related to higher mortality risk compared to

other histological subtypes (bromyxoid sarcoma: HR: 5.2, 95% CI 0.71-

38.1; rhabdomyosarcoma: HR: 2.93, 95% CI 1.44-6.00; hemangiosarcoma:

HR: 1.07, 95% CI 0.53-2.18).

Discussion: As a point of criticism of the present study one hast to be

aware that data from a single cancer registry might lead to selection bias.

erefore, prospective analyses should include multiple cancer registries

with patients from dierent social and ethnic backgrounds.

Conclusion: Histological grade, tumor size, nodal and distant metastasis,

tumor localization and histological subtype were determined as prognos-

tic factors in terms of survival.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts204

233

Genitourinary sarcoma in adults: A population-based analysis

of tumor characteristics, incidence and survival in North

Rhine-Westphalia (NRW)

Rainer Hamacher1; Lennart Möller2; Hiltraud Kajüter2; Christine Eisfeld2;

Mohamed Assahub3; Christopher Darr4; Boris Hadaschik4;

Sebastian Bauer1; Andreas Stang2; Viktor Grünwald3

1University Hospital Essen, Department of Medical Oncology, West German

Cancer Center, Essen, Deutschland

2Cancer Registry of North Rhine-Westphalia, Bochum, Deutschland

3University Hospital Essen, Interdisciplinary Genitourinary Oncology at the

West-German Cancer Center, Clinic for Internal Medicine (Tumor Research) and

Clinic for Urology, Essen, Deutschland,

4University Hospital Essen, Department of Urology, Essen, Deutschland

Background: Sarcomas of the genitourinary (GU) tract are rare. We ana-

lyzed the incidence and survival in North Rhine-Westphalia regional can-

cer registry.

Methods: Patients ≥18 years were identied based on ICD-O-3 morphol-

ogy and topography codes. Only ma-lignant tumors (behaviour 3) were

included. Age-standardized incidence rates (ASR) were calculated (old

European Standard). Descriptive statistics were conducted, stratied by

histological subtypes and tumor locations. Kaplan-Meier curves were uti-

lized for survival analyses.

Result: We identied 1,392 incident cases (f/m N=1,102/290) from 2008-

2019. e ASR for GU sarcoma was 0.49/105 (95%-CI 0.46-0.52) with

0.77/105 (95%-CI 0.72-0.82) for females and 0.20/105 (95%-CI 0.18-0.22)

for males. In females, for gender-specic tumors, the majority presented

in the uterus (N=890; 81%), vulva/vagina (N=55; 5%) and ovary (N=40;

4%). e most common histological subtypes were leiomyosarcoma

(N=456; 41%), endometrial stromal sarcoma (N=312; 28%) and adeno-

sarcoma (N=87; 8%). In males the majority presented at the spermatic

cord (N=78; 27%), testis (N=57; 20%) and prostate (N=22; 8%). e most

common histological subtypes in men were liposarcoma (N=111; 38%),

leiomyosarcoma (N=80; 28%) and undierentiated sarcoma (N=21; 7%).

In both sexes, bladder was the most common location in the urinary tract

(f/m=36/39) followed by the kidney (f/m=30/42). Here, the most common

histological subtypes were leiomyosarcoma (N=51; 35%) and liposarcoma

(N=9; 6%). e median overall survival was 69.3 months (95%-CI 56.7-

89.0). In the total cohort, the 5-year survival probability was in females

52% (95%-CI 49-55%) and in males 51% (95%-CI 45-58%).

Discussion: Sarcomas of the GU tract show higher incidence for females

and gender-dependent dierences for histological subtypes. e 5-year

survival probability did not show a gender dierence.

Conclusion: Further analysis have to address the impact of histology and

topography on prognosis.

Disclosure Statement: e authors declare the following: Viktor Grünwald reports

institutional funding with a grant from AstraZeneca for the MEDOSARC study.

All the other authors declare no conict of interest.

255

Transferability of cancer registry data to clinical practice in

retroperitoneal sarcoma

Franziska Neemann1; Lina Jansen2; Christian Silcher1; Bernd Kasper1;

Peter Hohenberger1; Jens Jakob1

1Mannheim University Hospital, Mannheim, Deutschland

2Epidemiological Cancer Registry Baden-Württemberg German Cancer

Research Center (DKFZ), Heidelberg, Deutschland

Background: Retroperitoneal sarcomas (RPS) are a rare, heterogeneous

tumor group for which valid data is needed to guide treatment. To date,

these come from cohorts on general so tissue sarcomas. Cancer registries

(CR) may be another possible source. It is questionable whether patients

recorded in CR are comparable to an expert cohort in patient and tumor

characteristics. is work compares CR and TARPS data to assess the rep-

resentativeness of TARPS and the quality of CR data.

Methods: e TARPS cohort includes patients of primary RPS (years

2002 - 2011) and surgery in specialized centers (1). e CR Baden-

Württemberg cohort includes all patients with primary RPS M0 (years

2016 - 2021, ICD-10 C.49.4/5, C48.x) and surgery within 12 months. To

optimize the non-specic localizations (C48.x), only sarcoma-typical

ICD O codes were chosen (see Onkozert certication). Patient, tumor,

and therapy factors (Chi² Test) and overall survival (Kaplan Meier) were

compared.

Result: A total of 1007 (TARPS) and 319 (CR) patients were included.

Patients in the CR cohort were signicantly older (+9 years), had higher

grading and a dierent histology distribution. e gender distribution,

R status and proportion of patients with chemo- and radiotherapy were

comparable. However, CR patients were less likely to have chemotherapy

or radiotherapy before surgery. e 3-year survival probability was lower

(73%) compared with TARPS (77%).

Discussion: e TARPS data are highly selected due to recruitment in spe-

cialized centers and have high data quality. CR data are population-based

and thus representative of all RPS patients, but data quality is dependent

on completeness and quality of reporting. Dierent codes make it dicult

to compare cohorts.

Conclusion: Overall, the quality of CR data appears sucient to represent

a cohort of RPS patients. It is important to optimize the reporting process

for sarcomas to use the existing data from the nationwide cancer registries

in the future.

Indication of source:

1 doi: 10.1002/cncr.33139.

Disclosure Statement: e authors declare no conict of interest.

324

Recurrent Hematothorax Following Epithelioid Angiosarcoma

of the Pleura

Niels Michael Dörr-Jerat1; Jürgen Knolle2; Claus Jürgen May1;

Sykle Schmidt3; Marcus Krüger1

1Klinik für Thoraxchirurgie, Krankenhaus Martha Maria Halle/Dölau, Halle

(Saale), Deutschland

2Klinik für Pathologie, Krankenhaus Martha Maria Halle/Dölau, Halle (Saale),

Deutschland

3Klinik für Anästhesiologe, Krankenhaus Martha Maria Halle/Dölau, Halle (Saale),

Deutschland

Purpose: We present a case of a female patient with recurrent bilateral

hemothorax. Aer misdiagnosis despite multiple histologic specimens, a

pleural manifestation of epithelioid angiosarcoma was diagnosed by fur-

ther immunohistologic staining. Based on this case we would like to sen-

sitize the reader for this rare disease.

Methods: is is a case report of an extremely rare pathology of the

pleura. About 30 case reports have been published so far. Our experience

is discussed against the background of previous case reports.

Results: A 73-year-old fully conscious woman presented with dyspnea of

3 days’ duration. She was in a stable general condition, without cardiopul-

monary events, not on anticoagulation medication. Physical examination

revealed decreased breath sounds on the le side, hemoglobin was 7.0

mmol/l.

Initial chest x-ray showed a le pleural eusion. A hemothorax was diag-

nosed. Workup showed no evidence of malignancy (CT, EBUS, cytology,

etc.). VATS was performed and biopsies of pleural abnormalities did not

provide congruent ndings of hemothorax. e additional pathologi-

cal report aer further processing revealed an epitheloid angiosarcoma

dened by massively proliferating epitheloid cells strongly positive for

ERG and CD31, negative for CD34.

Discussion: is case highlights the need for good communication

between surgeons and pathologists. Even when biopsies are suitable for

diagnosis, misdiagnosis may occur due to misinterpretation of the clini-

cal course, misunderstanding of tumor localization and cell morphology,

leading to inappropriate immunohistochemical staining programs.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 205

Conclusion: Physicians treating spontaneous hemothorax must have a

broad knowledge of the possible and sometimes rare etiologies. Pleural

angiosarcoma should be considered in the dierential diagnosis of recur-

rent hemothorax.

Disclosure Statement: e authors declare no conict of interest.

686

Health related Quality of Life over time in German sarcoma

patients. - An analysis of associated factors - results of the

PROSa study

Martin Eichler; MSc.1; Leopold Hentschel2; Susanne Singer3; Bernd Kasper4;

Dimosthenis Andreou5; Daniel Pink6; Karin Arndt7; Martin Bornhäuser1;

Jochen Schmitt8; Markus Schuler9

1Universitätsklinkum Dresden, MK1 & NCT/ UCC, Dresden, Deutschland

2Universitätsklinikum Dresden/ NCT/ UCC, Dresden, Deutschland

3Universitätsmedizin Mainz, IMBEI, Mainz, Deutschland

4Universtitätsklinikum Mannheim, Sarkomzentrum, Mannheim, Deutschland

5Medical University of Graz/ Department of Orthopedics and Trauma, Graz,

Österreich

6Helios Hospital Bad Saarow/ Sarcoma Center Berlin-Brandenburg, Bad Saarow,

Deutschland

7Deutsche Sarkomstiftung, Wölfersheim, Deutschland

8Universitätsklinkum Dresden, ZEGV & NCT/ UCC, Dresden, Deutschland

9Universitätsklinkum Dresden, MK1, Dresden, Deutschland

Background: Sarcomas are rare cancers and very heterogeneous in their

location, histological subtype, and treatment. Health-Related Quality of

Life (HRQoL) of sarcoma patients has rarely been investigated in longi-

tudinal studies.

Methods: Here, we assessed adult sarcoma patients and survivors between

September 2017 and February 2020, and followed-up for one year in 39

study centers in Germany. Follow-up time points were 6 (t1) and 12 months

(t2) aer inclusion. We used a standardized, validated questionnaire (the

European Organisation for Research and Treatment of Cancer Quality

of Life Core Instrument (EORTC QLQ-C30) and explored predictors of

HRQoL in two populations (all patients (Analysis 1), patients in ongoing

complete remission (Analysis 2)) using generalized linear mixed models.

Result: In total we included up to 1111 patients at baseline (915 at t1, and

847 at t2), thereof 387 participants were in complete remission at baseline

(334 at t1, and 200 at t2). When analyzing all patients, HRQoL diered

with regard to tumor locations: patients with sarcoma in lower extrem-

ities reported lower HRQoL values than patients with sarcomas in the

upper extremities. Treatment which included radiotherapy and/ or sys-

temic therapy was associated with lower HRQoL. For patients in complete

remission, smoking was associated with worse HRQoL-outcomes. In both

analyses, bone sarcomas were associated with the worst HRQoL values.

Being female, in the age group 55-<65 years, having lower socioeconomic

status, and comorbidities were all associated with a lower HRQoL, in both

analyses. HRQoL increased partially over time since treatment and with

sporting activities.

Discussion: HRQoL improved with time since treatment, although not in

all domains, and was associated with lifestyle and socioeconomic factors.

Bone sarcomas were the most aected subgroup.

Conclusion: Methods to preserve and improve HRQoL should be devel-

oped for sarcoma patients.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

821

Proton Therapy in Patients with Parameningeal Soft Tissue

Sarcoma – Results of the Prospective Registry Studies ProReg

and KiProReg

Beate Timmermann1; Christine Hansel2; Dalia Ahmad Khalil2; Yi-Lan Lin2;

Monika Sparber-Sauer3; Xavier Vermeren2; Christoph Blase4;

Stephan Tippelt5; Sebastian Bauer6; Rolf-Dieter Kortmann2

1Klinik für Partikeltherapie, Universitätsmedizin Essen, Westdeutsches

Protonentherapiezentrum Essen (WPE), Westdeutsches Tumorzentrum (WTZ),

Deutsches Konsortium für Translationale Krebsforschung (DKTK), Deutschland,

Essen, Deutschland

2Klinik für Partikeltherapie, Universitätsmedizin Essen, Westdeutsches

Protonentherapiezentrum Essen (WPE), Westdeutsches Tumorzentrum (WTZ),

Deutschland, Essen, Deutschland

3Klinikum der Landeshauptstadt Stuttgart GKAöR, Olgahospital, Stuttgart

Cancer Center, Zentrum für Kinder-, Jugend- und Frauenmedizin, Pädiatrie 5

(Pädiatrische Onkologie, Hämatologie, Immunologie), Medizinische Fakultät,

University of Tübingen, Stuttgart, Deutschland

4AnästhesieNetz Rhein-Ruhr, Bochum, Deutschland, Bochum, Deutschland

5Universitätsmedizin Essen, Kinderklinik III, Pädiatrische Hämatologie und

Onkologie, Westdeutsches Tumorzentrum (WTZ), Essen, Deutschland, Essen,

Deutschland

6Innere Klinik (Tumorforschung), Universitätsmedizin Essen, Westdeutsches

Tumorzentrum (WTZ), Sarkomzentrum Essen, Deutschland, Essen, Deutschland

Background: Proton therapy (PT) is an important therapy for patients

with parameningeal so tissue sarcomas (PM-STS). PT delivers a unique

dose distribution and therefore spares organs at risk limiting risks for

adverse events. We analyzed the outcome of patients with PM-STS.

Methods: Patients treated from January 2014 - July 2023 for PM-STS

and enrolled to our in-house registry studies KiProReg and ProReg were

included in this analysis. Data on patient and tumor characteristics, ther-

apy and adverse events (according to CTCAEv4/5) was evaluated.

Result: 93 patients (90 children, 3 adults) met inclusion criteria (51 m,

42 f; median age 7.1 yrs, range 1.1-50.4). 89 patients were diagnosed with

rhabdomyosarcoma. All patients underwent chemotherapy prior to PT;

79 patients concurrent to PT. ree patients received previous radiother-

apy within the same radiation area. Complete resection before PT was

achieved in nine patients. All patients were treated at the primary tumor

site. PT was delivered in adjuvant (29.0%) or denitive (71.0%) setting.

Median dose of PT was 55.8 Gy (range 40.0-59.4 Gy), delivered in 31 frac-

tions (range 16-33 fractions). Median FU time was 2.3 yrs. (range 0.4-12.9

yrs.). Tumor control was achieved in 67 patients. 16 patients developed

local progression; ten patients developed dissemination. Four patients

were treated with a second course of PT at relapse. 16 patients died. ree-

year overall survival, progression free survival and local control were 79%,

63% and 71%, respectively. Acute higher grade (>grade 2) toxicities con-

cerned fatigue or pain (n=2), dermatitis (n=5) and blood (n=21; anemia,

leukopenia, neutropenia or thrombopenia), during PT. Long term higher

grade toxicities concerned dermatitis (n=1), oral mucositis (n=1), blood

(n=1), neoplasm (n=1 Leukemia), skin and subcutaneous tissue (n=3),

eye disorders (n=8; cataract, conjunctivitis, optic nerve disorder, vision

decrease) and others (n=1).

Conclusion: PT seems safe and eective in patients with PM-STS. Results

have to be conrmed in a longer FU.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts206

Skin Cancer including Melanoma

561

Preliminary ndings from a phase II study show promising

results in overcoming primary resistance to checkpoint

inhibitors among patients with advanced melanoma using

intermittent alkylating chemotherapy

Lucie Heinzerling1; Sebastian Haferkamp2; Bastian Schilling3;

Carola Berking4; Edward Geissler5; Florian Zeman6

1Klinik und Poliklinik für Dermatologie und Allergologie der LMU München,

München, Deutschland

2Universitätsklinikum Regensburg, Klinik und Poliklinik für Dermatologie,

Regensburg, Deutschland

3Hautklinik - Uniklinikum Würzburg, Würzburg, Deutschland

4Hautklinik des Uni-Klinikums Erlangen, Erlangen, Deutschland

5Universitätsklinikum Regensburg, Experimentelle Chirurgie, Regensburg,

Deutschland

6Universitätsklinikum Regensburg, Zentrum für klinische Studien,

Regensburg, Deutschland

Background: Patients with BRAF wildtype (wt) metastatic melanoma with

primary resistance to immune checkpoint inhibitors (ICI) have an appall-

ing prognosis. Chemotherapy has been shown to alter factors that inuence

response to ICI like genetic mutations, tumor microenvironment, microbi-

ome and immune system. is phase II trial investigates whether two doses

of an alkylating agent called dacarbazine (DTIC) can render patients with

primary resistance to ICI responsive to the same ICI treatment.

Methods: Within the study, 39 patients are included at four skin cancer

centers. Patients receive two doses of DTIC (850 mg/m2 i.v.) on days 1

and 21, followed by re-exposure to the same ICI therapy they had previ-

ously shown resistance to. Using a two-step design, the expected response

rate was set at 20%, with an uninteresting response rate of 5% (one-sided

alpha of 5% and 90% power). Response was dened as complete or partial

response by week 14.

Result: At interim analysis, 29 patients were evaluable for the primary

endpoint of tumor response according to RECIST 1.1. e overall response

rate was 24% (90% CI: 12-41%), with seven out of 29 patients showing a

partial response. e disease control rate was 38% (11 out of 29 patients).

e treatment was well tolerated, with 16% of patients experiencing grade

3 or higher adverse events and no new safety signals.

Discussion: Short-term chemotherapy can break resistance to ICI ther-

apy in a subgroup of patients. is nding is signicant as this treatment

approach could be easily translated into clinical practice. Investigation of

longitudinal biological samples (serum, plasma, PBMC, tissue and stool

samples) will provide further insights into the mechanisms associated

with rendering patients responsive.

Conclusion: e administration of two doses of DTIC can break ICI resis-

tance in patients with metastatic melanoma. is observation justies the

continuation of this phase II trial to assess eectiveness and mechanisms

of this approach. e enrollment is ongoing. Clinical trial: NCT04225390.

Sponsor: German Cancer Aid; University hospitals.

Disclosure Statement: e authors declare that there are conicts of interest.

econicts were submitted to the congress organizer KUKM GmbH and KUKM

can disclose them if needed.

Supportive Care

Reasons for encounter and recommended complementary

and integrative health care measures in cancer patients –

results of the implementation study “CCC-Integrativ”

Andreas Schmitt1; Stefanie Joos1; Cornelia Mahler2; Regina Stolz1;

Holger Mauch1; Jan Valentini1

1Institute for General Practice and Interprofessional Care, University Hospital

and Faculty of Medicine Tuebingen, Tuebingen, Deutschland

2Department of Nursing Science, Institute for Health Sciences, University

Hospital and Faculty of Medicine Tuebingen, Tuebingen, Deutschland

Background: Complementary and integrative healthcare (CIH) is becom-

ing more common as a complement to conventional cancer treatment.

We conducted a controlled interprofessional implementation study with

n=1,128 oncology patients (CO=443, IG=685) at four Comprehensive

Cancer Centers in BW, Germany. is abstract analyzes which reasons for

encounter (RfE) led to which CIH interventions within the study.

Methods: Prior to the study, we dened 20 common symptoms of cancer

patients, for which we evaluated evidence-based CIH measures in a multi-

stage procedure. Every patient received three consultations and a counseling

letter aer each consultation. e data of the letters were analyzed using quali-

tative content analysis. e RfE were categorized by the ICPC-3-classication.

Results: 1809 counseling letters of 603 patients were included. A total of

4397 RfE were documented (7/patient). Fatigue was most common (56%),

followed by digestive complaints (51%), general complementary medicine

issues (44%), polyneuropathy (41%), mucosal problems (40%) and others.

A total of 8342 CIH measures were recommended (14/patient). Nearly

all patients received recommendations on non-medical procedures (98%)

and on external applications (92%), a majority on phytotherapeutics or

tees (79%) and acupressure (79%). Recommendations on non-medical

procedures included nutritional counseling (94%), exercise (92%) and

relaxation techniques (80%).

Discussion: Interprofessional evidence-based CIH counseling covers a

wide range of cancer patients’ concerns and complaints. Recommended

measures range from life-style recommendations (exercise, diet,

relaxation) to specic CIH applications like acupressure, external appli-

cations, phytotherapeutics and others. Within the CCC-Integrativ study,

we were able to show that a variety of methods from dierent medical

systems can be used for a variety of specic RfE.

Conclusion: Our counseling was tailored according to the best available

evidence and integrates both medical and nursing aspects in an overarch-

ing counseling concept.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 207

Results of the module nutrition in the CARE for CAYA

program – a need-based multimodal lifestyle survivorship

program focusing on physical activity, nutritional behavior

and psychological processes in survivors of cancer

inchildhood, adolescence and young adulthood

Julia von Grundherr1; Simon Elmers1; Luisa Samland1; Raika Mühlberg1;

Gabriele Calaminus2; Sonja Schuster3; Annette Sander4; Alexander Puzik5;

Inken Hilgendorf6; Judith Gebauer7; Michael Köhler8; Jörg Faber9;

Nicole Salzmann10; Magdalena Sokalska-Duhme11; Claudia Metz12;

Lisa Schimann13; Luzia Valentini14; Freerk T. Baumann15; Eik Vettorazzi16;

Jannike Salchow1; Sarah Dwinger17; Alexander Stein1;

Carsten Bokemeyer1; Marianne Sinn1

1Department of Oncology, Hematology, BMT with Section Pneumology,

Hubertus Wald Tumor Center - University Cancer Center Hamburg, University

Medical Center Hamburg-Eppendorf, Hamburg, Deutschland

2Department of Pediatric Hematology and Oncology, University Hospital Bonn,

Venusberg Campus 1, Bonn, Deutschland

3Abteilung für pädiatrische Hämatologie und Onkologie, Kinder- und

Jugendklinik, Universitätsklinikum Erlangen, Erlangen, Deutschland

4Medizinische Hochschule Hannover, Klinik für Pädiatrische

Hämatologie-Onkologie, Hannover, Deutschland

5Department of Pediatric Hematology and Oncology, Medical

Center - University of Freiburg, Faculty of Medicine, University of Freiburg,

Freiburg, Deutschland

6Klinik für Innere Medizin II, Abteilung für Hämatologie und Internistische

Onkologie, Universitätsklinikum Jena, Jena, Deutschland

7Department of Internal Medicine I, University Hospital of Schleswig-Holstein,

Campus Luebeck, Lübeck, Deutschland

8Department of Hematology and Oncology, University Hospital Magdeburg,

Magdeburg, Deutschland

9Department of Pediatric Hematology/Oncology, Center for Pediatric and

Adolescent Medicine – University Cancer Center, (UCT), University Medical Center

of the Johannes Gutenberg-University Mainz, Mainz, Deutschland

10University Children‘s Hospital Muenster, Pediatric Hematology and Oncology,

Münster, Deutschland

11Department of Pediatric Hematology, Onkology & Immunology, Olgahospital,

Klinikum Stuttgart, Stuttgart, Deutschland

12Clinic for Pediatrics III, Department of Pediatric Hematology/Oncology, West

German Cancer Centre, University Hospital, Essen, Essen, Deutschland

13Institute of Clinical Epidemiology and Biometry, Julius-Maximilians-Universität

Würzburg, Würzburg, Germany CCC WERA, University Hospital Würzburg,

Würzburg, Deutschland

14University of Applied Sciences, Faculty of Agriculture and Food Sciences,

Neubrandenburg, Deutschland

15Department I of Internal Medicine, Center for Integrated Oncology

Aachen Bonn Cologne Dusseldorf, University Hospital, of Cologne, Cologne,

Deutschland

16Institute for medical Biometry and Epidemiology, Hamburg, Deutschland

17Department for Medical Psychology, University Medical Center

Hamburg-Eppendorf, Hamburg, Deutschland

Background: Children, adolescents and young adult cancer survivors

(CAYAs) are oen aected by late and long-term eects. Studies have shown

that a healthy diet and weight can lower the risk of secondary diseases. e

module nutrition of the CARE for CAYA program (CFC-P) was designed to

reduce the need for nutritional interventions among CAYAs.

Methods: An initial RCT compared need-based modular interventions to

usual care for CAYAs aged 15–39 years in 14 German clinics (December

2017–July 2020). A comprehensive assessment was conducted to identify

needs in nutrition, physical activity and psycho-oncology (T1). If a ‘high

need’ was identied in Nutrition, the intervention group (IG) received ve

counselling sessions and the control group (CG) one. Primary outcome

was changes in the dietary quality aer 52 weeks (T3) measured with

Healthy Eating Index (HEI-EPIC) in points (pts) based on 3-day dietary

records (classication in good ≥ 65 pts, moderate > 40–65 pts or poor

≤ 40 pts dietary quality). Secondary outcomes were e.g. mediterranean

dietary quality (MEDAS-FFQ), fatigue (EORTC-C30) and quality of life

(EORTC-C30).

Results: A total of 357 CAYAs participated in the RCT, 63.0% were female

and median age was 25.0 years.

Aer 52 weeks, the ‘high need’ in Nutrition decreased in both groups,

from 75.2% to 71.8% in the IG and from 77.9% to 67.3% in the CG. Due

to the study design, modular endpoints were assessed on an exploratory

basis. Regarding the primary outcome dietary quality, median HEI-

EPIC score improved aer 52 weeks in both groups, in IG (T1=48.0 pts;

T3=52.0 pts) and in CG (T1=48.0 pts; T3=51.5 pts). us, ‘high need’

criteria poor dietary quality improved from 27.1% to 14.9%. Concerning

secondary endpoints, improvements in mediterranean dietary quality as

well as fatigue and quality of life scores were observed in both groups.

Conclusion: e CFC-P showed a high need for nutritional support

among the CAYAs. Dietary quality was moderate and should be improved,

the HEI-EPIC score improved slightly aer 52 weeks. It seems reasonable

to provide at least one nutritional counseling.

Disclosure Statement: e authors declare the following: AOK Germany, Astra

Zeneca, Bayer Healthcare, BioNTech, Bristol Myers Squipp, Jansen Cilag, med

update, Merck Serono, On-cology Drug Consult CRO, Roche Pharma, Sano

Aventis, Hamburg Cancer Society, National Network of German Cancer Cen-ters,

Northern German Society of Internal Medicine, DGHO, BeiGene, Janssen-

Ciliag, medac, Celgene, JazzPharmazeuticals, Fondazione Internationale Menarini,

BMS, MSD, Incyte, Pzer, Servier, Amgen, Incyte, Pierre Fabre, Biegene, AbbVie,

Novartis.

Building a nationwide safety net for oral antitumor therapy:

SafetyFIRST - a cluster-randomized stepped-wedge trial

Julia Schwanfelder1,2; Katja Schlichtig2; Lars Wismar3; Christian Staerk4;

Andreas Mayr4; Martin F. Fromm2; Ulrich Jaehde3; Frank Dörje1

1Pharmacy Department, Erlangen University Hospital, Erlangen, Deutschland

2Institute of Experimental and Clinical Pharmacology and Toxicology, Friedrich-

Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Deutschland

3Department of Clinical Pharmacy, Institute of Pharmacy, Rheinische Friedrich-

Wilhelms-Universität Bonn, Bonn, Deutschland

4Institute of Medical Biometry, Informatics and Epidemiology, University

Hospital Bonn, Bonn, Deutschland

Background: Several challenges in the use of oral antitumor therapies

(OAT) require close patient and medication management. e AMBORA-

trial1 demonstrated considerable benets of an intensied clinical phar-

macological/pharmaceutical care program in patients with various tumor

types: Less medication errors and (severe) adverse events were observed

and patient perception improved. Safety-FIRST aims to assess the trans-

ferability and ecacy of this program in a nationwide setting with heter-

ogenous care settings.

Methods: A SafetyFIRST competence center was established to train 24

interprofessional tandems comprising community/ hospital pharmacies

and oncology ambulatory clinics/ practices. Using a cluster-randomized

trial with a stepped-wedge design, the study will evaluate standard versus

the intensied interprofessional care with at least 600 patients. e pri-

mary outcome is a combined endpoint of severe adverse events (CTCAE

≥3), treatment discontinuation, unscheduled hospital admission, and

death, in accordance with one AMBORA-trial’s endpoint1.

Result: 24 participating tandems were successfully recruited. A workshop

with around 70 attendees addressed healthcare professionals’ roles, scien-

tic evaluation, and strategies to overcome implementation barriers. e

results were considered for generation of the nal study protocol. Patient

recruitment will begin in January 2024, accompanied with a status quo

survey on interprofessional collaboration within the tandems.

Discussion: In a nationwide approach, SafetyFIRST aims to enhance

medication safety, strengthen patient competence, and improve interpro-

fessional collaboration. Upon data completion, the ndings will be used

for potential integration of the intervention into routine medical care to

ensure sustainable benets.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts208

Conclusion: SafetyFIRST represents a promising step forward in enhanc-

ing patient safety in OAT through an intensied interprofessional care

program in heterogenous care settings.

1 Dürr P, Schlichtig K, Kelz C, et al. J Clin Oncol 2021, 39: 1983–1994.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

143

Physical activity in people with lung cancer during systemic

antitumor therapy in an oncology day-clinic initiated by

nurses - development of a person-centered physical activity

concept with patient participation

Ramona Engst1; Andrea Kobleder1; Joachim Wiskemann2; Nicola Greco3;

Anastasios Manettas3,4; Steen Heinrich1; Caroline Tanner5; Antje Koller1

1Eastern Switzerland University of Applied Sciences, Departement of Health,

Institute of Applied Nursing Science, St. Gallen, Schweiz

2National Center for Tumor Diseases (NCT) Heidelberg, Department of Medical

Oncology, Heidelberg, Deutschland

3University Hospital, Department of Physiotherapy and Occupational Therapy

(PEU), Zurich, Schweiz

4University of Thessaly, Department of Physical Education and Sport Science,

Biomechanics and Ergonomics, ErgoMech Laboratory, Trikala, Griechenland

5Eastern Switzerland University of Applied Sciences, Departement of Health,

BSc Physiotherapy, St. Gallen, Deutschland

Purpose: Physical activity is eective in reducing side eects and increasing

well-being in lung cancer patients. However, there is no systematic approach

to promote physical activity during the stay in oncology day clinics before,

during and aer therapy. erefore, the aim of this project is to develop an

evidence-based physical activity concept for people with lung cancer in the

oncology outpatient day-clinic. It is designed to be supervised by nursing

sta to be realized by the cancer patients themselves.

Methods: An interprofessional expert panel (n=15) was engaged over 7

months (2022/23) in three rounds based on the delphi method to select

evidence-based activities for people with lung cancer potentially and

safely applicable by oncology nurses and the interprofessional team.

Result: According to the experts, the nurse-led physical activity concept

for an oncology outpatient day-clinic is based on ve core components:

(1) team approach, (2) activities in a modular structure, (3) person-

centeredness, (4) a safety-, and (5) a communication-concept.

(1) Team approach: Each person in the interprofessional team contrib-

utes with their unique role in routine care

(2) ree modules (Mds): Md1 - mild activities for everyone. Md2 - mild

intensity exercises selected and performed with the nurses. Md3 -

referrals to indication-based professionally guided training

(3) Person-centeredness: Wishes, experiences and potentials of individ-

ual patients are assessed and integrated

(4) e safety concept includes contra-indications, hygiene, injury avoid-

ance and other

(5) e communication concept enables teams to act in concert

Discussion: e expert discussion has shown that a catalogue with exer-

cises alone is not sucient, but that ve core components are central to a

physical activity concept. While the ve components are mandatory, the

concept remains exible and adaptable, by providing guidance on local

individual adjustments for each component.

Conclusion: In a next step the eectiveness of the program and impact on

lung cancer patients’ outcomes will be tested.

Disclosure Statement: e authors declare no conict of interest.

145

Implementation of regular lifestyle counseling during

long-term follow up care of childhood cancer survivors

Franziska Richter1; Lea Kronziel2; Inke König2; Thorsten Langer1;

Judith Gebauer3

1Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Klinik für Kinder-

und Jugendmedizin, Pädiatrische Onkologie und Hämatologie, Lübeck,

Deutschland

2Universität zu Lübeck, Institut für Medizinische Biometrie und Statistik,

Lübeck, Deutschland

3Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Medizinische Klinik I,

Leitung Interdisziplinäre Langzeitnachsorge, Lübeck, Deutschland

Background: Many childhood cancer survivors (CCS) develop treat-

ment-related late eects, including increased risk of obesity and metabolic

syndrome. A healthy lifestyle can reduce the risk of associated comorbidi-

ties. erefore, at-risk CCS could benet from lifestyle counseling during

regular long term follow up (LTFU).

Methods: Lifestyle counseling was implemented within LTFU care over

the study period of one year. Metabolic markers and activity levels were

prospectively evaluated as screening parameters for dierent risk groups.

Perspectives of CCS, physician and sports scientist were compared to

identify those CCS with the highest need of counseling. A follow-up

appointment aer one month was performed.

Result: During LTFU care, 155 CCS (65% female, 35% male) aged between

18 and 63 years (median:30 years) were contacted. 112 CCS (72%) had an

indication for lifestyle counseling based on assessments from physicians,

sports scientists, or themselves. Among them, 45% were aected by meta-

bolic disorders and 46% did not meet the recommended activity levels. A

total of 120 CCS (77%) received lifestyle counseling, including 8 CCS who

initially did not desire a counseling, but were open for recommendations.

ose who underwent intensive cancer treatment showed the highest

need. During follow-up, CCS indicated high adherence to recommenda-

tions and successful implementation into their daily lives. Nearly all sur-

vivors (97%) found the provision of lifestyle counseling during regular

LTFU benecial.

Discussion: Prediabetic conditions aected 19% of CCS, with 6% bene-

ting despite not meeting criteria. Due to limited resources, it’s crucial to

deliberate on the inclusion criteria for lifestyle counseling.

Conclusion: Incorporating specialized healthcare professionals into sur-

vivorship care enhances the multidisciplinary approach and can aid in

promoting a healthy lifestyle, potentially reducing long-term morbidity

among CCS.

Disclosure Statement: e authors declare no conict of interest.

247

Needs analysis of oncological patients with taste

disorders - an interim analysis of the TASTE Guide study

Raika Mühlberg1; Julia von Grundherr1; Luisa Samland1; Lena Pro2;

Carsten Bokemeyer1; Martin Schönlein1; Anne Overlach1; Jennifer

Hagemann1; Marianne Sinn1

1Department of Oncology, Hematology, BMT with Section Pneumology,

Hubertus Wald Tumor Center - University Cancer Center Hamburg, University

Medical Center Hamburg-Eppendorf, Hamburg, Deutschland

2Hamburg University of Applied Sciences (HAW Hamburg), Hamburg,

Deutschland

Purpose: erapy-associated taste disorders and hence nutritional behav-

ior is a common and due to malnutrition a clinically relevant problem in

oncological patients undergoing systemic therapy. Up to 2/3 of patients

are described to have changes in the taste perception. e aim of this study

is to identify patients’ needs for support and to improve nurses’ knowledge

of nutrition and taste disorders in oncology patients; and enable them to

provide initial information. Training of nurses will start in October 2023.

Methods: e study is divided into 1) a training of nursing sta and 2)

a survey with out- and inpatients to determine the need for support and

risk of malnutrition. e applied one-time survey consists of a needs

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 209

assessment for side eects (self-developed), an assessment of the risk for

malnutrition and side eects (PG-SGA short form), assessment of taste

and smell perception (medical history form by Prof. Hummel) and inter-

est in nutritional counseling.

Results: e TASTE Guide trial currently has enrolled 100 patients (65%

inpatients, 60% female, median age was 58 years (20-86 years)). e most

common tumor entities were gynecologic tumors (n=34), multiple mye-

loma (n=16) and gastrointestinal tumors (n=11). 73% received a chemo-

therapy, 18% radiation therapy and 28% surgery. Until August 2023, smell

and taste disorders were reported by 35% of patients and 19% specically

reported taste disorders. e mostly self-reported other therapy-associ-

ated side eects were: fatigue (28%), nausea (28%) and loss of appetite

(20%). In the PG-SGA survey at baseline assessment, 31% of patients had

a high risk of malnutrition, 34% a moderate risk, 24% a low risk, and 10%

no risk. Furthermore, 43% of patients expressed interest in receiving a

nutritional counseling.

Conclusion: e side eects are varied; a large proportion of patients

have a risk for malnutrition and reported small and taste disorders. e

expressed need for nutrition counselling was high among these patients.

Disclosure Statement: e authors declare no conict of interest.

327

SOCOFIN - A Digital Study on the Assessment of Financial

Toxicity as a Result of Radiotherapy

Anna Luisa Kreuser1; Rami El Shae1; Oliver Rick2; Sonia Ziegler1;

Thomas Asendorf3; Friederike Braulke4; Stefan Rieken1;

Stephanie Bendrich1; David Alexander Ziegler1; Jan Oelmann1;

Manuel Guhlich1; Martin Leu1; Leif Hendrik Dröge1; Laura Anna Fischer4;

Jann Fischer4; Charlotta Friederike Pagel1

1Universitätsmedizin Göttingen, Göttingen, Deutschland

2Klinik Reinhardshöhe, Bad Wildungen, Deutschland

3Institut für Medizinische Statistik - UMG, Göttingen, Deutschland

4UniversitätsKrebszentrum Göttingen, Göttingen, Deutschland

Background: Financial burden associated with cancer treatment has

become a signicant concern for patients. It may include loss of income

and other out-of-pocket expenses, leading to “nancial toxicity” (FT).

Studies have shown that FT not only adversely aects quality of life1

but also correlates with higher mortality rates2. Interestingly, it can be

detected in patients both without and with health insurance3. However,

limited research is available in European countries, particularly Germany,

a state with public health insurance.

Methods: e rst-time longitudinal exploratory study will assess FT

(COST-12) of patients undergoing radiotherapy in Germany at baseline,

at the end of radiotherapy and three months aerwards. Risk factors and

secondary outcomes include socio-economic factors, health-related qual-

ity of life (EORTC QLQ-C30), depression (PHQ-9), coping mechanisms,

and sense of coherence (SOC Scale). e ocial start of the study is July

6th, 2023, with the aim to enroll about 300 patients. Data is collected using

an electronic case report form, RedCap, both based on RedCap online

surveys and a new mobile app, Patienta.

Result: e primary analysis involves the full analysis set of all patients

with complete primary and secondary outcome. Linear regression is used

to assess the relation between primary and secondary outcomes. Interim

analysis is planned when 75 patients have completed the surveys.

Discussion: e study aims to bridge the knowledge gap on FT of patients

undergoing radiotherapy in Germany. By identifying risk factors, the

impact on quality of life as well as treatment outcomes, the study will con-

tribute valuable insights to address FT in cancer care.

Conclusion: is longitudinal study on FT of patients undergoing

radiotherapy will provide data to further understand FT. e results will

contribute to identify the necessity of strategies to alleviate FT faced by

patients during cancer treatment aiming at improving overall outcomes

and treatment adherence.

Disclosure Statement: e authors declare no conict of interest.

333

Physical Activity as a Treatment for Cancer-Related Fatigue in

Children, Adolescents and Young Adults: A Systematic Review

Mareike Kühn1; Lena Wypyrsczyk1; Sandra Stössel1; Marie A. Neu1;

Lisa Ploch1; Elias Dreismickenbecker1; Perikles Simon2; Jörg Faber1

1Universitätsmedizin Mainz, Klinik und Poliklinik für Kinder- und

Jugendmedizin, Schwerpunktbereich Pädiatrische Hämatologie/ Onkologie/

Hämostaseologie, Mainz, Deutschland

2Institute of Sport Science, Department Sport Medicine, Rehabilitation and

Disease Prevention Johannes Gutenberg University, Mainz, Deutschland

Background: Cancer-related fatigue (CRF) is one of the most common

and distressing symptoms in pediatric oncology. Based on previous stud-

ies, physical activity interventions are considered eective in reducing

CRF in adult cancer patients. However, few studies have investigated the

eect of exercise interventions on CRF in pediatric oncology. e aim of

this systematic review is to investigate whether physical activity interven-

tions can reduce CRF in pediatric patients undergoing cancer treatment.

Methods: A systematic literature search was conducted in PubMed and Sport-

Discus in October 2021 to identify intervention studies examining the eects

of physical activity on CRF in cancer patients’ under 21 years of age. eir

methodological quality was assessed using the JBI Critical Appraisal Tool.

Result: A total of 20 studies (seven randomized controlled trials, six quasi-ex-

perimental studies and seven single-arm intervention studies) were included

in the review. Nine studies reported signicant positive eects of physical

activity interventions on CRF in-group comparison or within groups in child-

hood cancer patients. Eleven trials reported no signicant changes in CRF.

Discussion: e relevance of promoting physical activity as a therapeutic

measure in oncology has been demonstrated by the extensive discussion

of physical activity in oncology and its presence in the current literature.

Regardless of the type of exercise intervention oered, positive eects of phys-

ical activity on CRF and other health-related outcomes are evident. However,

the study situation in the eld of pediatric oncology is very heterogeneous and

shows a wide range with regard to quantitative data on exercise normative.

Conclusion: Physical activity as a therapeutic intervention in pediatric

oncology may have the potential to reduce CRF in childhood cancer

patients undergoing cancer treatment. Further high-quality studies with

large samples are needed to verify these ndings and to assess the interde-

pendence of dose and response of physical activity interventions.

Disclosure Statement: e authors declare no conict of interest.

381

Enhanced screening in geriatric cancer patients-Inclusion

ofsymptom burden as a distressing factor

Lea Büthe; Judith Büntzel

Universitätsmedizin Göttingen, Göttingen, Deutschland

Background: A previous geriatric screen (G8 screening tool) in hematoon-

cological inpatients (HP) showed that a large proportion of HP were identi-

ed as at risk. In this pilot cohort mainly items of nutrition screened positive.

Considering malnutrition is relevant for prognosis and toxicities in elderly

HP, there is a need for a more extensive screening tool to assess not only

malnutrition, but also for contributing factors like symptom burden (SB).

Methods: Elderly HP (> 65 a) at a single center were routinely screened

using the validated screening tools „G8“ and „NRS2002“ in combina-

tion with items addressing SB and dietary changes. Microso excel and

GraphPad Prism were used for data management and statistical analysis

(Student’s unpaired t-test, Fisher’s exact test).

Result: No signicant dierence in BMI was detected between age groups

(age < 75 a; age ≥ 75 a; p= 0.07). Overall, 154/201 (77%) HP were positive

in prescreen (NRS2002); of those 141/154 (92.0%) HP were diagnosed with

malnutrition. Concerning Symptom burden, most HP suered from xeros-

tomia (59%; 119/201), loss of appetite (41%; 82/201), constipation (28%;

56/201), loss of taste (28%; 56/201), bloating (27%; 54/201) or nausea (24%;

48/201). ere was a signicantly higher frequency (p=0.02) of dental pros-

thesis provision and associated problems in patients with solid tumors.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts210

Discussion: e reasons of malnutrition are manifold. However, there

are recurring symptoms both in solid and hematological cancer patients.

Xerostomia in particular is an underestimated stress factor. Patients with

solid tumors were more likely to have problematic dental restorations and

were signicantly more likely to have complaints with their teeth.

Conclusion: Malnutrition is still an underestimated problem in older HP.

e application of our modied screening tool does not only capture mal-

nutrition itself but also underlying causes (diet changes, SB). Especially SB

should be considered when optimizing supportive care in HP.

Disclosure Statement: e authors declare no conict of interest.

444

Patients’ perceived competencies in dealing with

disease-related challenges up to one year after acute

treatment of breast or gynecological cancer

Natascha Fahmer1; Hermann Faller1; Achim Wöckel2; Jessica Salmen2;

Peter Heuschmann1,2; Karin Meng1,2

1Julius‐Maximilians‐Universität Würzburg, Würzburg, Deutschland

2Universitätsklinikum Würzburg, Würzburg, Deutschland

Background: Our study aims to investigate patient competencies to deal

with disease-related challenges across the disease course. As a framework,

we assumed that patient competencies reect an interplay of personal

skills/abilities and situational demands.

Methods: We surveyed 100 patients (breast, cervical, endometrial, or

ovarian cancer) and three measurement occasions (t1-t3; acute treatment,

6- and 12-month follow-up). To assess challenges, competencies, and sup-

portive care needs, we used a self-developed questionnaire that comprises

25 items referring to coping tasks assigned to six domains, e.g., informa-

tion, physical complaints, health behavior, psychological distress (1). We

analyzed data, calculating frequencies, percentages, and cross-tabulations

with ‘challenges’ (‘moderate/very much’) and ‘competencies’ (‘yes/no’).

Result: e most common challenges with at least moderate severity (at

least 50%; t1 to t3) lie in coping with psychological distress (e.g., dealing

with fears and insecurities) and in dealing with physical complaints (e.g.,

dealing with reduced capacity). e proportion of women with subjectively

experienced competence in dealing with these individually relevant chal-

lenges is between 43% and 75% during acute treatment. ese proportions

increase throughout the disease for most challenges (t3: 52 to 88%).

Discussion: e results illustrate the diversity and the change in individ-

ual disease-related challenges, perceived competencies, and support needs

up to one year aer the acute treatment.

Conclusion: Oers to strengthen patients’ coping skills should exist longer

term and be accessible according to individual needs. Patient competence

can be promoted through several components. However, empowerment

and patient-oriented care are essential.

Indication of source:

1 Fahmer, N., Faller, H., Wöckel, A., Salmen, J., Heuschmann, P. & Meng, K.

(2023). Patients’ perceived challenges, competencies, and supportive care

needs during acute clinical treatment of breast or gynecological cancer.

Psychooncology, 32, 682–691.

Disclosure Statement: e authors declare no conict of interest.

458

Is spirituality a resource for cancer patients?

Sebastian Ruhe1,2; Helmut Orawa3; Jutta Hübner2; Jens Büntzel1

1Südharz Klinikum Nordhausen, Klinik für Hals-Nasen-Ohrenheilkunde,

Nordhausen, Deutschland

2Universitätsklinikum Jena, Klinik für Innere Medizin II, Am Klinikum 1, Jena,

Deutschland

3Universitätsklinikum Jena, Institut für Medizinische Statistik, Informatik und

Datenwissenschaften, Jena, Deutschland

Background: Religiosity and hidden spirituality are important for over-

coming challenges in life. Until now spiritual care (SpC) is limited for pal-

liative practice. Is it a resource for cancer patients too?

Methods: We asked cancer patients via questionnaire for demograc data,

and to report about follwing issues: spiritual needs (SpNQ-20), self cat-

egorization of spirituality/religiosity, awe and gratitude (GrAw-7), subje-

tive well being (WHO-5), general self-ecacy (ASKU), life satisfaction

(L1-scale), lay etiology concepts, CAM use, ability to change (PIAC scale).

Via SPSS we used following methods for statistical analysis – U-test for

comparing dierences between groups, Spearmen correlations for descrip-

tions of relationships between dependent factors, the Welch test for com-

paring our study population with reference data, mediation analysis for

describing the impact of spirituality on CAM use.

Result: We included 108 patients (41 female, 63 male, 4 no data, median age

66 yrs, range 30-89). 56 patients were christians, 1 patient islamic, further 51

had no membership in a religious group. Cancer type – breast 23, head neck

cancer - 38, prostata - 7, hematological malignances - 6, others – 34. Church

membership or S/R+ self categorization indicate higher levels of needs. Inner

peace, generativity, existentials occur in all patients independetly their religion.

Spiritual experiences (GrAw-7) correlates with all needs. S/R categorization and

spiritual experiences (GrAw-7) correlate with WHO-5 and L-1 scale. ere is

only a weak correlation between GrAw-7 and PIAC, ASKU and lay etiologies.

S/R self categorization and GrAw-7 have correlate with CAM use. Mediations

demonstrate the direct impact of spirituality on CAM use, enhanced by per-

sonal religiosity, experiences (GrAw-7) and discovered needs (SpNQ-20).

Conclusion: We have to discover the hidden needs of our patients to

understand their mental situation. SpC oers and new diagnostic instru-

ments are possible parts of patient’s empowerment.

Disclosure Statement: e authors declare no conict of interest.

515

The prophylactic hand-foot-cooling Hilotherapy® avoids CIPN

during chemotherapy - is the eect sustainable? Update of

the 4-year Follow UP data

Trudi Schaper; Maren Darsow

Luisenkrankenhaus GmbH, Düsseldorf, Deutschland

Background: Using the hand-foot cooling Hilotherapy® during tax-

ane-based chemotherapy reduced the development of chemotherapy-

induced polyneuropathy (CIPN) ≥ grade 2 signicantly (Schaper et al.

2019). Now the 4-year long-term results are available, to conrm the

Hilotherapy® as a useful and sustainable CIPN prevention.

Methods: In our pilot study 151 breast cancer patients used the degree-

specic cooling system Hilotherm Chemo Care for prophylactic constant

hand-foot cooling (1/2018 – 5/2019). e extremities were cooled during

each chemotherapy (CTX). Cooling was administered 30 minutes before

to 30 minutes aer CTX (device temperature setting 10-12°C). Aer each

CTX-treatment, CIPN symptoms were assessed using CTCAE criteria. To

conrm the sustainability of results, the evaluation of long-term data was

assessed at months 4, 7, 13, 24, 36 and 48.

Result: Out of 151 patients using the prophylactic Hilotherapy®, 141 patients

(93.4%) developed none or mild symptoms of CIPN (grade 0: n=64; grade

1: n = 77). 10 patients (6.6 %) suered from grade 2, 1 patient from grade 3

(0.8%). Symptoms of CIPN were improved partly: 4 weeks aer the last che-

motherapy treatment (EOT) 102 patients (67.5%) showed no toxicities (grade

0), 42 patients (27.8%) had mild symptoms (grade 0-1: n=10 & grade 1: n =

32), 6 patients (4%) suered from grade 2, none showed grade 3 toxicity. 4 – 48

months aer completing CTX 93.0% – 95.8% of all patients are free of ≥ grade

2 CIPN symptoms (grade0-1: months 4 = 94.7%; months 7 = 95.8%; months

13 = 94.0%; months 24 = 93.0%; months 36 = 93.4%; months 48 = 93.7%).

Discussion: CIPN is a severe side eect of many commonly used che-

motherapeutic agents, especially taxane-based regimen (Paclitaxel, nab-

Paclitaxel, Docetaxel) which reduces patients health-related quality of life

for years. Furthermore, it oen entails dose delays, dose reductions or

treatment discontinuations.

Conclusion: e results of this real-world data study propose the prophy-

lactic constant cooling (Hilotherapy®) as a new approach to prevent CIPN

≥ grade 2 signicantly.

Disclosure Statement: e authors declare the following: Advisory borads, Rei-

seerstattungen, Vortragshornore.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 211

526

Adherence and impact of a supervised digital training

program on motor performance and HRQoL: Study protocol

Nicole Soinski1; Gunnar Cario1; Anouk Riou2; Thorsten Schmidt3

1Universitätsklinikum Schleswig-Holstein, Campus Kiel, Klinik für Kinder-und

Jugendmedizin, Kiel, Deutschland

2Universitätsklinikum Schleswig-Holstein, Campus Kiel, Zentrum für integrative

Psychiatrie (ZIP), Kiel, Deutschland

3Universitäres Cancer Center Schleswig-Holstein UCCSH, Kiel, Deutschland

Background: Children and adolescents move less than their peers dur-

ing and aer oncological treatment and show reduced ﬁtness and health

related quality of life (HRQoL). e concept of telemedicine is a prom-

ising approach to expand the care structure and to reduce barriers such

as distance, time and costs. e purpose of this study is to investigate

whether a digital training program can be implemented in pediatric

oncology. It investigates adherence, motor performance, and HRQoL.

Results from a previous pilot study showed that a digital exercise program

is feasible and safe in pediatric oncology. It seemed promising in terms of

improving motor performance and HRQoL. is study aims to conrm

these assumptions.

Methods: 20 children and adolescents aged 6 to 18 years with an ini-

tial diagnosis who are undergoing cancer treatment will be included.

e intervention extends over a period of 12 weeks with prescribed 2

training sessions/week. e rst 3 training sessions are carried out

under direct supervision of a sports therapist and then completed by

the participants themselves under weekly telemedical supervision. Each

patient’s individual plan is accessible from any location via internet.

Adherence is measured by the number of completed prescribed training

sessions/week. Motor performance will be assessed at baseline (T0) and

12 weeks (T2). HRQoL will be measured at baseline (T0), 8 weeks (T1)

and 12 weeks (T2).

Result: Since March 2023, 7 patients were included with an ongoing

recruitment.

Discussion: is study investigates the adherence of a digital exercise

program and its impact on motor performance and HRQoL in children

and adolescents with cancer during treatment. If this study is success-

ful, digital exercise therapy may potentially help to increase HRQoL and

maintain or even improve motor performance in children and adolescents

with cancer. e possibility of digital and location-independent training

could also enable qualied sports therapy regardless of the distance to a

top oncological center.

Disclosure Statement: e authors declare no conict of interest.

547

Kolibri: An explorative long-term study on exercise and

its inuence on physical performance and psychosocial

aspects in childhood cancer patients during and after

cancertreatment

Lena Wypyrsczyk; Mareike Kühn; Elias Dreismickenbecker;

Marie A. Neu; Franziska Ortmüller; Jörg Faber

Universitätsmedizin Mainz, Klinik und Poliklinik für Kinder- und Jugendmedizin,

Schwerpunktbereich Pädiatrische Hämatologie/Onkologie/Hämostaseologie,

Mainz, Deutschland

Background: Medical advances in childhood cancer treatment have sig-

nicantly improved survival rates, increasing the importance of address-

ing long-term eects. Oncological treatment and its side eects are oen

associated with reduced physical activity leading to decits in physical

performance. Recent research indicates that specically tailored exercise

therapy has the potential to reduce treatment-related side eects, enhance

psychosocial outcomes, and optimize physical performance. e study’s

objective is to assess physical and psychosocial functioning of children

and adolescents, in order to expand the knowledge of targeted exercise

therapy in the future.

Methods: A total of 100 children and adolescents between the ages of 3

and 21 with a cancer diagnosis will be enrolled in the trial. Patients will

be recruited during cancer treatment and aercare. Aer inclusion, par-

ticipants will complete physical performance tests (endurance, strength,

mobility, coordination, balance and gait), a questionnaire program

(cancer-related fatigue, quality of life, resilience, mental health, pain)

and an assessment of physical activity and sedentary behavior at multiple

timepoints over a 5-year period.

Result: Patient enrollment started in June 2023. e elaborated compila-

tion of various physical performance tests proved to be feasible and well

accepted. To increase accessibility and response rates, a web-based appli-

cation was developed to allow remote access and use of the questionnaires.

Discussion: e progress already seen in the early stages of the trial is

promising. e data collected provides an insight into the functional sta-

tus of the enrolled patients in terms of physical performance and high-

lights disease- and therapy-related decits.

Conclusion: In the long term, the number of variables collected as well as

the extended time of observation will provide a comprehensive view of the

development of functional status in childhood cancer patients and may

contribute to the evidence base for targeted exercise therapy.

Disclosure Statement: e authors declare no conict of interest.

638

Oncological Exercise Therapy (OTT) with AYA patients in a

clinical context – Results of real-world data

Lena Böhlke; Sophia Printzen; Timo Niels; Freerk T. Baumann

Universitätsklinikum Köln, Centrum für integrierte Onkologie (CIO) Aachen,

Bonn Köln, Düsseldorf, Klinik für Innere Medizin, Köln, Deutschland

Background: AYA patients represent a group for whom it is particularly

important to maintain mental and physical performance during and aer

oncological treatment. Participation parameters, mental health, and phys-

ical tness of AYA patients in an exercise program implemented in a clin-

ical setting will be evaluated.

Methods: An analysis of real-world data of AYA patients who partici-

pated in Oncological Exercise erapy (OTT) at the University Hospital

of Cologne, Germany, between the years 2012 and 2019 was conducted.

Demographic, medical and treatment-associated data of AYA patients

were documented at enrollment. Questionnaires and physical assessments

are used to assess mental health and physical tness during participation

in OTT Program. e sample was analyzed descriptively. e statistical

analysis to determine the eectiveness of the program follows.

Result: A sample of n=227 AYA patients was enrolled over 8 years. First

data show most patients were female (72.7%), with a mean age of 32 years,

diagnosed with breast cancer (39.2%) and during medical treatment

(74%). Additional data on patients’ mental health and physical tness will

be presented at the congress. ese are expected to show a positive eect

of the exercise program.

Discussion: To our knowledge, this is the rst time such real-world data

has been collected and evaluated for AYA patients in an exercise therapy

care model.

Conclusion: While the OTT program has been shown to reach AYA

patients during oncology treatment in a clinical setting, the data suggest

that exercise programs specically tailored to AYA patients are needed to

meet their needs.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts212

672

Get Strong to Fight Childhood Cancer: An Exercise

Intervention for Children and Adolescents Undergoing

Anti-Cancer Treatment (FORTEe)

Elias Dreismickenbecker1; Francesca Lanfranconi2; Marie A. Neu1;

Sandra Stössel1; Lisa Ploch1; Norbert W. Paul3; Christian Ruckes4;

Adriana Balduzzi2; Peter Wright5; Stan Windsor5; Joachim Wiskemann6;

Inaam El Rajab6; Veronika Picmanova7; Barbara Heisserer7;

Rodolf Mongondry8; Wilhelm Bloch9; Katie Rizvi10; Martin Fridh11;

Alejandro Lucia12; Carmen Fiuza-Luces13; Miriam Götte14;

Filippo Spreaco15; Barbara Konda16; Milica Stefanovic17;

Marco Sowa-Israel18; Tobias Baader19; Jörg Faber1

1University Medical Center of the Johannes Gutenberg-University Mainz,

Department of Pediatric Hematology/ Oncology, Center for Pediatric and

Adolescent Medicine, Mainz, Deutschland

2Fondazione Monza e Brianza per Il Bambino e La Sua Mamma, Clinica

Pediatrica, Università degli Studi di Milano Bicocca, Monza, Italien

3University Medical Center of the Johannes Gutenberg-University Mainz,

Institute for the History, Philosophy and Ethics of Medicine, Mainz, Deutschland

4University Medical Center of the Johannes Gutenberg-University Mainz,

Interdisciplinary Centre for clinical Studies (IZKS), Mainz, Deutschland

5Oxford Brookes University, Department of Sport and Health Science and Social

Work, Oxford, United Kingdom

6Heidelberg University Hospital and National Center for Tumor Diseases,

Department of Medical Oncology, Working Group Exercise Oncology,

Heidelberg, Deutschland

7Concentris research management GmbH, Project Management,

Fürstenfeldbruck, Deutschland

8Centre de Lutte Contre le Cancer Léon Bérard, Prevention Cancer Environment

Department, Lyon, Frankreich

9German Sport University Cologne, Department of Molecular and Cellular Sport

Medicine at the Institute of Cardiology and Sports Medicine, Köln, Deutschland

10Youth Cancer Europe, Youth Cancer Europe, Cluj-Napoca, Rumänien

11Department of Pediatrics and Adolescent Medicine, University Hospital

Rigshospitalet, Kopenhagen, Dänemark

12Universidad Europea de Madrid, School of Doctorate Studies and Research,

Madrid, Spanien

13Hospital 12 de Octubre Research Institute, ‚imas12‘, Physical Activity and

Health Laboratory, Physical Activity and Health research group (PaHerg),

Madrid, Spanien

14Essen University Hospital, Exercise Oncology Working Group, West German

Cancer Center, Essen, Deutschland

15Fondazione IRCCS Istituto Nazionale dei Tumori, Pediatric Oncology Unit,

Mailand, Italien

16Forma 3D Ltd, Forma 3D, Ljubljana, Slovenia

17University Medical Center Ljubljana, Division of Pediatrics, Department of

Haematooncology, Ljubljana, Slovenia

18Nurogames GmbH, Nurogames, Köln, Deutschland

19Pixformance Sports GmbH, Pixformance Sports, Dallgow-Döberitz,

Deutschland

Background: Cancer is the leading cause of death by non-communica-

ble diseases in children in Europe. During cancer treatment, patients’

morbidity is increased due to e.g. physical inactivity and cancer-related

fatigue. Personalized exercise training during the intensive phase of can-

cer treatment in children and adolescents is a promising therapy to mit-

igate above mentioned issues. However, evidence for using exercise to

counteract fatigue and improve health-related quality of life is lacking in

pediatric oncology.

Methods: e FORTEe research project intends to evaluate a personalized

and standardized exercise intervention in 450 children, adolescents and

young adults undergoing cancer treatment in nine centers across Europe.

is randomized, controlled multicenter trial aims to generate high evi-

dence for an innovative, patient-centered exercise treatment as part of the

standard of care. Experiences and expertise in pediatric exercise oncol-

ogy within Europe were merged to develop specic exercise training and

testing protocols which are to be implemented with the help of digital,

innovative technologies.

Result: e elaborated protocols are standardized to enable adapted per-

sonalized exercise training. A meticulous approach to tailored exercise

includes a sensitive functional evaluation system to set the appropri-

ate exercise dosage, aiming at dening type, frequency and intensity.

Precision exercise training protocols are adapted and personalized to

the cancer patient’s clinical phenotype. e intensity, time and volume of

exercise are adjusted to the cancer treatment intensity and to each patient’s

clinical condition and response. For this purpose, dierent modalities are

included that allow training sessions in-person but also remotely, sup-

ported by innovative technologies.

Conclusion: As a progress beyond the current state-of-the-art, FORTEe

has the ambition to implement pediatric exercise oncology as an evi-

dence-based standard in clinical care for all childhood cancer patients

worldwide.

Disclosure Statement: e authors declare no conict of interest.

673

Strategies to overcome “uninformed consent” in clinical trials

with cancer patients: A mixed-methods approach to increase

patient understanding and ensure fair access to optimal

cancer care

Christine Bernardi1; Daniel Wol2; Daniel Heudobler2; Florian Lüke2;

Johannes Hies3; Frederike Seitz4; Lisa Boyer1; Tobias Pukrop2;

Wolfgang Herr2; Anne Herrmann-Johns1,5

1Institut für Epidemiologie und Präventivmedizin / Medizinische

Soziologie Regensburg, Regensburg, Deutschland

2Universitätsklinikum Regensburg / Innere Medizin III Hämatologie und

Internistische Onkologie, Regensburg, Deutschland

3Universitätsklinikum Regensburg / Rechtsangelegenheiten, Regensburg,

Deutschland

4Universität Regensburg / Ethikkommission, Regensburg, Deutschland

5University of Newcastle (UoN) / School of Medicine and Public Health,

Newcastle, Australien

Background: In accordance with legal and ethical requirements,

patients should be thoroughly informed about clinical trials in which

they could enroll. is oen leads to lengthy informed consent (IC)

processes during which patients are faced with complex and unfamil-

iar information. is project will develop and pilot test strategies to

improve IC processes.

Methods: Using semi-structured phone interviews, we investigated the

perspectives of cancer patients enrolled in clinical trials, their support

persons (SPs) and IC experts from various elds. Based on these ndings

and using a mixed-methods design, strategies to improve IC processes

were developed and will be tested in a randomized controlled trial.

Result: Most patients and SPs (n=43) felt adequately informed about the

respective trial. However, core aspects of the trial were oen not under-

stood, highlighting a discrepancy between perceived and actual under-

standing. Experts stressed that patients and SPs were oen overwhelmed

by information. Strategies to overcome this can be grouped into three

categories: i) improvement of IC documents, ii) re-structuring the IC con-

versation (e. g. by using a brief conversation protocol), and iii) improved

communication training for all involved stakeholders. ese strategies are

currently being rened with the help of a multidisciplinary expert panel

and will be tested in a subsequent study.

Discussion: Our ndings indicate a lack of cancer patient and SP

understanding of key elements of clinical trials. Due to the discrepancy

between their perceived and actual understanding, clinicians may over-

estimate which information patients actually recall and understand. e

identied strategies could help to improve doctor-patient-communica-

tion in this area.

Conclusion: is is the rst German study to examine the views of cancer

patients, SPs and further experts on IC processes in oncology. Rening

and testing evidence-based communication strategies is likely to facil-

itate fair access to clinical trials and thus foster the provision optimal

patient-centered cancer care.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 213

696

Implementation of the tumor board “Supportive Case

Conference” to improve the quality of life of oncological

patients

Eva Schneider1; Iris Bey2; Dirk Waldschmidt3

1University Hospital Cologne, Oncology Nursing Department, Nursing

Directorate, Köln, Deutschland

2University Hospital Cologne, Center for Integrated Oncology (CIO),

Interdisciplinary Tumour outpatient Clinic, Köln, Deutschland

3University Hospital Cologne, Clinic for Gastroenterology and Hepatology, Köln,

Deutschland

Background: In the course of treatment at the Center for Integrated

Oncology (CIO) of the University Hospital of Cologne, highly complex

overall situations of individual oncological patients oen arise that cannot

be satisfactorily resolved with the usual symptom-oriented methods. An

interprofessional consultation aims to enable these patients to cope better

with their disease, the medical therapy and undesired side eects.

Methods: First, a working group of 12 dierent disciplines was formed.

is resulted in the “Supportive Case Conference”, consisting of oncol-

ogy specialist nurses, CIO Patient Navigator, physicians, pastoral care,

psychooncology/psychosomatics, pain specialists, social services, onco-

logical exercise therapists, dietetics, natural medicine, traditional Chinese

medicine and palliative medicine specialists. Patients are introduced by a

member of the treatment team, usually a nurse.

Result: Aer a one-year test phase, the “Supportive Case Conference” has

become established and takes place every two weeks as a hybrid meet-

ing. e interdisciplinary recommendations are implemented promptly

(usually within 36 hours) and evaluated at the next meeting. e patients

benet greatly from the detailed discussion of their situation. Also for the

therapeutic team the results lead to a relief.

Discussion: e next steps to be taken are to increase the frequency, to

improve public relations and to integrate scientic outcome assessment.

Conclusion: e “Supportive Case Conference” has proven to be a suc-

cessful instrument for quality improvement in the interdisciplinary care

of heavily burdened oncological patients. e overarching guiding vision

of the CIO nds practical application here: “Together against cancer.

Together for life.”

Disclosure Statement: e authors declare the following: wissenschaliches.

701

ESPRIT – Testing the eectiveness of a social prescription

andvirtual patient information to increase tertiary prevention

in cancer patients

Lisa Boyer1; Christine Bernardi1; Sabine Einhell2; Michael Leitzmann3;

Michael Koller4; Tobias Pukrop2; Wolfgang Herr2; Anne Herrmann-Johns1,5

1Institut für Epidemiologie und Präventivmedizin/Medizinische Soziologie

Regensburg, Regensburg, Deutschland

2Universitätsklinikum Regensburg/Innere Medizin III Hämatologie und

Internistische Onkologie, Regensburg, Deutschland

3Institut für Epidemiologie und Präventivmedizin, Regensburg, Deutschland

4Universtitätsklinikum Regensburg/Zentrum für Klinische Studien (ZKS),

Regensburg, Deutschland

5University of Newcastle (UoN)/School of Medicine and Public Health,

Newcastle, Australien

Background: Tertiary prevention through physical activity (PA) and

psychosocial support can improve outcomes of cancer patients, includ-

ing increased survival. However, adoption rates of tertiary prevention

programs remain low. Social prescriptions provide individually tailored

care plans, referring patients to non-clinical services. While they pro-

vide a promising strategy to improve health behavior, further evidence is

required to evaluate their eectiveness. Support persons (SPs) are oen an

important source of information for patients, yet their role in facilitating

patient health behavior remains understudied.

Methods: A single-center randomized controlled trial (RCT) will test the

eectiveness of a social prescription (intervention A) and virtual patient

information (intervention B) in promoting the uptake of PA, social

engagement and psychosocial support among cancer patients and SPs,

in comparison to usual care. Secondary endpoints will encompass over-

all quality of life and self-ecacy of patients and SPs. e study will also

investigate cost-eectiveness, the duration of consultations and further

implementation barriers and enablers. We will examine the endpoints at

baseline, at 3, 6 and 12 months of follow-up.

Result: is is an ongoing study conducted at Comprehensive Cancer

Centre Ostbayern, which serves patients residing mainly in rural areas.

Initial ndings will be presented.

Discussion: is project aims to provide causal evidence regarding the

eectiveness of innovative strategies for enhancing preventive health

behavior and improving outcomes for cancer patients and SPs. A

mixed-methods hybrid design will help to identify eective strategies and

facilitate their integration into routine care.

Conclusion: We will employ evidence-based communication strategies

and a comprehensive, low-cost approach to promote an active lifestyle

among cancer patients and SPs. ese interventions promise a high degree

of adaptability, making them suitable for widespread adoption to address

the needs of various vulnerable patient populations.

Disclosure Statement: e authors declare no conict of interest.

715

Feasibility of exercise as a supportive measure for patients

undergoing checkpoint-inhibitor treatment: A randomized

controlled trail

Jana Müller1; Friederike Rosenberger1; Jessica Cecile Hassel2;

Joachim Wiskemann1

1National Center for Tumor Diseases (NCT) and Heidelberg University Hospital,

Working Group Exercise Oncology, Division of Medical Oncology, Heidelberg,

Deutschland

2National Center for Tumor Diseases (NCT) and Heidelberg University Hospital,

Heidelberg, Deutschland

Background: Immune checkpoint inhibitors, such as the PD-1 antibodies

pembrolizumab and nivolumab, are the standard of care for patients with

metastatic melanoma. ey have signicantly prolonged patient survival,

but also entail some side eects. In addition to the immune-mediated side

eects, fatigue is the most frequent side eect. e SPORTIVUMAB pilot

study investigated safety and feasibility of an exercise intervention pro-

gram (supervised resistance and endurance training) in patients undergo-

ing immune checkpoint inhibitor therapy.

Methods: Forty-eight patients (mean age 60 years; 44% female) were

enrolled. Among other measures, fatigue (MFI) and quality of life

(EORTC QLQ-C30) were assessed at baseline (before the start of immune

checkpoint inhibitor therapy) and aer 12-weeks follow-up. Aer baseline

testing, patients were randomized to the intervention (n=25) or control

group (n=23). Patients randomized to the intervention group trained 2x/

week for a total of 12 weeks during immune checkpoint inhibitor therapy

with a PD-1 antibody.

Result: e dropout rate was 17% (IG n=4, CG n=4), allowing n=40

patients to be included in the intention-to-treat (ITT) analyses. Training

adherence was 62% on average (15 out of 24 prescribed training sessions).

No (S)AEs occurred that were related to the exercise intervention. ITT

revealed no dierences regarding fatigue and quality of life (p>.05).

Discussion: e lack of eects on fatigue and quality of life could be

explained by a lack of adequate training stimulus due to the relatively

low adherence. e eect of the intervention on other patient reported

outcomes, endurance capacity, and management of immunotherapy side

eects need to be investigated in further analyses (results are available for

the DKK Congress 2024).

Conclusion: Based on these preliminary analyses, supervised resistance

and endurance training is feasible in patients undergoing immune check-

point inhibitor therapy.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts214

740

“The most important thing is that you are not left alone” –

A Qualitative Study on Challenges, Coping and Needs of

Adolescents and Young Adults with Cancer Focusing on the

Life-Threat

Carolin Wilharm1; Saskia Blütgen1; Mara Weiß1; Anne Pralong1;

Michael Hallek2; Raymond Voltz1; Armin Tuchscherer2; Steen T Simon1

1Zentrum für Palliativmedizin Uniklinik Köln, Köln, Deutschland

2Klinik 1 für Innere Medizin Uniklinik Köln, Köln, Deutschland

Background: Cancer aects adolescents and young adults (AYA) at a life

period marked by transitions, where death seems far away. erefore, the

aim of this study was to explore the challenges, coping strategies, and

needs of AYAs with cancer focusing on the life-threat.

Methods: Patients aged between 18 and 39 years at diagnosis of any malig-

nancies were interviewed 2-5 years aer diagnosis when treatments had

been completed. Interviews were analyzed using qualitative content analysis.

Result: Fieen AYAs (mean 27,33y. at diagnosis, 9 female) were inter-

viewed. e sudden confrontation with existential concerns through a dis-

ease and its therapy, about which the AYAs knew little previously, led to

an emotional overload. AYAs experienced helplessness, fears and insecu-

rities that could restrict them in their entire life persistently. Nevertheless,

hope was described as prevalent throughout therapy. Simultaneously, most

avoided thoughts of a possible death. Others, however, found it soothing to

view death as acceptable or saw it as a chance to rethink their lives. Contact

with patients and survivors of the same age was described as helpful, but

witnessing their death posed a strong burden. Relatives were seen as the

main source of support, but AYAs also worried about them. Participants

had a high need for guidance and supporting services. Aer the end of ther-

apy, AYAs were challenged by the enduring changes in their lives that could

aect their careers and distanced them from healthy peers.

Discussion: Although there are similarities to older cancer patients, sig-

nicant dierences, such as inexperience and unexpectedness of a can-

cer diagnosis or the responsibility for own children, must be recognized.

ere are initial support services for AYAs unique needs, but these are far

from being suciently available.

Conclusion: Further research on AYAs’ needs regarding life-threat in a

curable state is needed. Expanding existing services and increasing inter-

action among health care professionals and patients, particularly in their

guidance, can improve the quality of care for AYAs.

Disclosure Statement: e authors declare no conict of interest.

773

Nutritional status of cancer patients in the rst year

afterdiagnosis

Judith Büntzel1; Milan Djordjevic2; Christoph Bauer-Büntzel3; Jens Büntzel2

1UMG Universitätsmedizin Göttingen, Göttingen, Deutschland

2Südharz Klinikum Nordhausen, Nordhausen, Deutschland

3Klinikum Fulda, Fulda, Deutschland

Background: Nutritional status is accepted as an independent prognostic

factor in the follow-up of cancer patients (pts). But - what is the normal

weight course on patient‘s way to cancer survivorship?

Methods: In a retrospective way we analyzed data of high-grade B-cell

lymphoma patients (HGBCL = systemic disease) and head neck cancer

patients (HNC = locoregional disease). Body weight, BMI, serum albumin

and C-reactive protein were (CrP) registered at time points T0 (diagno-

sis), T1 (+3 month), T2 (+6 month), T3 (+9 month), and T4 (+12 month).

To compare both groups we used an independent t-test, to compare the

course within a group, we used dependent instrument.

Result: We included 97 BCL and 49 HNC (101 male, 47 female). e

mean age was 63.08 +/-12.76 years. ere were no dierences between

both groups in age, BMI, and gender ratio. e course of nutritional status

diers signicantly (p<0.001): At time points T1/T2/T3/T4, HGBCL pts

have shown weight loss in 30.14/36.67/37.21/35.29% compared to HNC

pts in 35.56/56.52/54.55/47.73%. Weight gain was seen for HGBCL group

in 5.48/13.33/16.28/26.47% compared to 0/0/4.55/4.55% in HNC group.

Decreased albumin and increased CrP are typical for HGBCL pts at all

time points. HNC pts show only increased CrP at T1 and T2.

Discussion: Successfully treated high grade B cell lymphoma patients

(systemic diseases) will stabilize their nutritional status in the rst year

aer diagnosis. In contrast, head neck cancer patients (locoregional

diseases) will really start their nutritional challenge aer nishing their

cancer therapy.

Conclusion: Nutritional monitoring and support programs have the most

impact on cancer survivorship aer locoregional diseases and problems

(HNC, GI cancer).

Disclosure Statement: e authors declare no conict of interest.

781

Assessing nutrition status and tness in patients of an

interdisciplinary hemato-oncological university outpatient

clinic - feasibility and rst experiences

Manina Albrecht1; Sandra Windschüttl1; Florian Lüke1,2; Luzia Valentini3;

Tobias Pukrop1; Michael Koller1; Sabine Einhell1

1Universitätsklinikum Regensburg, Regensburg, Deutschland

2Fraunhofer-Institut für Toxikologie und Experimentelle Medizin ITEM,

Regensburg, Deutschland

3Hochschule Neubrandenburg, Neubrandenburg, Deutschland

Background: Hemato-oncological patients are treated according to cur-

rent guidelines. However, especially in borderline cases, objective and

universal parameters for decision making are oen missing in the daily

routine. e standardized assessment of nutritional and physical status

could support this process. erefore, the aim of this study was to evaluate

the time needed for a malnutrition and sarcopenia screening and to assess

their feasibility.

Methods: e prospective monocentric cohort study was conducted

over 3 consecutive visits (3-4 week intervals). Adult hemato-oncological

patients at the start of their actual therapy were included. Malnutrition

screening and diagnosis were performed using Patient-Generated

Subjective Global Assessment (PG-SGA) and Global Leadership Initiative

on Malnutrition (GLIM) criteria. Sarcopenia screening was performed

using Strength, Assistance with walking, Rise from a chair, Climb stairs

and Falls (SARF-F). Examination times were documented at each visit.

Result: Twenty-nine patients were included (69% men, 60 ± 14 years,

body mass index 26.1 ± 4.6 kg/m²). Screening time decreased from 33.4 ±

7.3 min at visit 1 to nally 20.5 ± 5.5 min at visit 3. Overall, 55.2 % (n=16)

of patients were at risk of malnutrition (n=14 moderate, n=2 sever)

according to PG-SGA. Malnutrition was diagnosed in 27.5 % of patients

(n=1 moderate, n=7 severe) using GLIM. A risk for sarcopenia (SARC-F

≥ 4 points) was detected in 20.7% (n=6) of patients.

Discussion: Even aer 3 visits, the assessments were still associated with

a signicant time requirement and could only be fully covered by an addi-

tional full-time dietitian. e percentage of patients with malnutrition

and risk of sarcopenia was within the range reported in the literature.

Conclusion: rough a reduction to key parameters, a feasible test set

has been identied. is will now be analyzed in a further study (BASiQ

Compass Trail) with a larger number of patients.

Disclosure Statement: e authors declare no conict of interest.

790

Decits in phytotherapeutic education amongst medical

stain cancer care

Gina Westhofen; Judith Büntzel

Klinik für Hämatologie und Medizinische Onkologie, Universitätsmedizin

Göttingen, Göttingen, Deutschland

Background: Cancer patients are known to use phytotherapy (PT), how-

ever, there is an information gap between the status quo of PT usage and

the actual knowledge of the medical sta (MS) about patients’ application:

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 215

e majority of patients does not inform their attending physicians about

PT usage, neither do these inquire about the topic in anamnesis. e aim

of our study was to evaluate 1) if MS assesses usage of PT and 2) the state

of knowledge on symptom focused PT.

Methods: An open questionnaire was completed by 108 participants (PA)

(64 medical students, 43 MS, 2 PA gave no information), allowing for

every PA to assess their own expertise, lack thereof and structural dicul-

ties in information transfer regarding PT. Using a numeric rating system

(1 - 6), a self-assessment for therapeutic options of dierent symptoms

was analyzed. Furthermore, the priority of PT anamnesis was evaluated.

Result: e survey was completed by 108 PA. PT anamnesis was rated as

important by 77% of the PAs, whereas only 41% stated to assess PT anam-

nesis on a regular basis (p = 0.1112). In self-assessment, all PAs claimed

a lack of consultation capacity, rating their own knowledge at a median

of 4 (physicians) and 5 (medical students and nurses), corresponding to

a failing grade. e overall rating, but also in every symptom category,

physicians assessed their consultation capacity better than students (p <

0.0001), in addition, physicians with pre-existing education in comple-

mentary and alternative medicine/PT rated their skills better than non

pre-educated colleagues (p = 0.0008). e majority of PAs stated PT coun-

selling falls within the responsibilities of physicians.

Discussion: Our survey conrms the known decits in PT competence

of MS. Furthermore, it suggests an unattended need for PT education and

knowledge transfer on PT usage amongst cancer patients.

Conclusion: ere is an unattended demand for PT education amongst

MS and medical students.

Disclosure Statement: e authors declare no conict of interest.

828

ONCOSCREEN – Evaluation of a psychosocial and supportive

care screening in cancer patients

Ilka Ratjen1; Friederike Stölzel2; Matteo Agius3; Romina Clemens3;

Lydia Cordesmeyer4; Felix Dittmann3; Lisa Gesewsky5; Evgeni Knispel3;

Marie von Lehmden3; Julia Medlin4; Livia Schmid3; Malte Fynn Söhl4;

Anna Franziska Hamm6; Christina Schwitlick7; Cyrus Khandanpour7;

Anne Letsch2

1University Hospital Schleswig-Holstein (UKSH), Kiel, Deutschland

2University Cancer Center Schleswig-Holstein, Kiel, Deutschland

3Christian Albrechts University, Kiel, Deutschland

4University of Lübeck, Lübeck, Deutschland

5C, Kiel, Deutschland

6University Hospital Schleswig-Holstein (UKSH), Lübeck, Deutschland

7University Cancer Center Schleswig-Holstein, Lübeck, Deutschland

Background: Many cancer patients do not report their supportive care

needs of their own volition. To identify cancer patients’ demand for

psychosocial and/or further supportive care, screening instruments are

routinely applied in certied cancer centers. ONCOSCREEN evaluates a

widened supportive cancer care screening (SCCS).

Methods: Starting in June 2023, participating in- and outpatient cancer

patients treated at the University Hospital Schleswig-Holstein are asked to

ll in SCS questionnaires, consisting of the NCCN Distress ermometer

and Problem List, the Minimal Documentation System, a nutrition

self-report questionnaire leaned on the Nutritional Risk Score and the

Minimal Nutritional Assessment, questions on physical activity from the

Bewegungs- und Sportaktivität questionnaire (BSA) and overall scores on

quality of life based on the EORTC QLQ-C30. As recruitment is ongoing,

preliminary data on study sample characteristics and psychosocial distress

are presented.

Result: Up to August 15th 2023, more than 326 patients participated

in ONCOSCREEN, comprising 145 patients with hematological,

41 urological, 41 nasopharynx/oropharynx/mouth, 39 gynecological, 38

gastrointestinal, 13 musculoskeletal, 8 lung and 1 neuroendocrine can-

cers. Mean age was 63±13.5 years (range, 19-89 y), 45% of the participants

were female. Mean value on the distress thermometer was 4,9±2,6, with

185 patients (57%) having a score of ≥ 5 which is dened as indication for

psychosocial care need.

Discussion: e ONCOSCREEN cohort consists of a broad range of

oncological patients representing the whole adult age range. Preliminary

results on psychosocial distress in ONCOSCREEN are in line with nd-

ings of other studies. A substantial proportion of patients show high dis-

tress scores exemplifying the need for psychosocial supportive care.

Conclusion: First results of the ongoing ONCOSCREEN-study show a

high need of psychosocial supportive care measures and reinforce the goal

of evaluating a comprehensive SCCS.

Disclosure Statement: e authors declare no conict of interest.

847

Three-year Experience of the Interdisciplinary CIO iTox-Board

for Management of Immune-Related Adverse Events with

Immune-Checkpoint Inhibition

Paul J. Bröckelmann1; Rieke N. Fischer1; Dirk Waldschmidt2; Michael

Faust3; Norbert Galldiks4; Katharina Seuthe5; Philipp Kasper2; Philipp Koll6;

Selina Hahn7; Alexander Quaas8; Thorsten Persigehl9; Michael Hallek1;

Cornelia Mauch6; Nicole Kreuzberg6

1University Hospital of Cologne, Department I of Internal Medicine, Center

for Integrated Oncology Aachen, Bonn, Cologne & Dusseldorf (CIO ABCD),

Cologne, Deutschland

2University Hospital of Cologne, Departmentof Gastroenterology and

Hepatology, Center for Integrated Oncology Aachen, Bonn, Cologne &

Dusseldorf (CIO ABCD), Cologne, Deutschland

3University Hospital of Cologne, Department of IV of Internal Medicine,

Cologne, Deutschland

4University Hospital of Cologne, Department of Neurology, Cologne,

Deutschland

5University Hospital of Cologne, Department of Cardiology, Cologne,

Deutschland

6University Hospital of Cologne, Department of Dermatology, Center for

Integrated Oncology Aachen, Bonn, Cologne & Dusseldorf (CIO ABCD), Cologne,

Deutschland

7CIO Cologne, University Hospital of Cologne, Center for Integrated Oncology

Aachen, Bonn, Cologne & Dusseldorf (CIO ABCD), Cologne, Deutschland

8University Hospital of Cologne, Department of Pathology, Cologne,

Deutschland

9University Hospital of Cologne, Department of Radiology, Cologne,

Deutschland

Background: Immune-checkpoint inhibitors (ICI) rapidly became main-

stay of contemporary cancer treatment and are increasingly utilized in

curative intent. Management of immune-related adverse events (irAE),

which may be life-threatening, is oen challenging. To improve manage-

ment of severe and/or steroid-refractory irAEs we established the inter-

disciplinary iTox-Board at CIO Cologne in 09/2020 and expanded it to the

CIO ABCD and aliated external caregivers in 10/2021.

Methods: Retrospective analysis of all referrals to our bi-monthly CIO

iTox-Board (09/20-08/23).

Results: A total of 121 suspected irAEs (median/month=3.4) aecting

102 patients with a median age of 64 years (range 25-86, IQR 57-70) were

discussed (CIO Cologne 82%, CIO ABCD external 11%). Lung (29%),

skin (19%), urologic (15%) and head & neck (14%) cancers were most

common. Most patients had stage 4 disease (87%), a response to ICI

(CR 10%, PR 37%, SD 30%, PD 23%) and impaired ECOG (median=1,

range 0-3, IQR 0-1) at iTox-Board consultation. Most patients received

pembrolizumab (52%) and ICI in combination with other agents (54%,

aPD1+aCTLA 22%, ICI+TKI 14%). Median time between start of ICI

and rst iTox-Board consultation was 2 months (range 0-94, IQR 1-7).

Suspected irAEs were mostly conrmed by the iTox-Board (86%), rarely

histologically veried (20%) and had a median severity of °3 (range 1-4,

IQR 2-3). Common leading irAEs were pneumonitis (15%), hepatitis

(14%), endocrine (13%), neurologic (10%), (cardio)myositis (8%) and

enteritis (8%). Multiple irAEs co-occurred in 18% of instances and ICI

discontinuation was recommended in 38% of cases.

Discussion: e CIO iTox-Board receives an increasing number of refer-

rals, including from external caregivers, and mostly provides guidance for

high-grade early onset potentially life-threatening irAEs.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts216

Conclusion: As a well-established regularly occurring interdisciplinary

conference, the CIO iTox-Board contributes to improved care of the rap-

idly growing number of patients receiving ICI-based treatments across

health-care sectors.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

866

„Aktiv leben mit Krebs“: acceptance and eect of a low-

threshold information on health behavior for cancer patients

Nadja Knauthe1; Vera Fieber1; Melanie Glausch1; Mark Enrik Geissler2;

Anna Dallal3; Konrad Doll3; Lisa Meister3; Marie Tallarek4;

Sandra Weigmann-Faßbender1; Nadine Giesemann1; Christine Hofbauer1;

Martin Bornhäuser1,5; Anne Letsch6; Ilka Ratjen7; Jacob Spallek4;

Friederike Stölzel6

1National Center for Tumor Diseases Dresden (NCT/UCC), Dresden, Deutschland

2Technical University of Dresden (TUD), Dresden, Deutschland

3Christian Albrechts University Kiel, Kiel, Deutschland

4Brandenburg University of Technology (BTU), Cottbus, Deutschland

5Universitätsklinikum Carl Gustav Carus Dresden, Medizinische Klinik und

Poliklinik I, Dresden, Deutschland

6University Cancer Center Schleswig-Holstein (UCCSH), Kiel, Deutschland

7University Hospital Schleswig-Holstein (UKSH), Kiel, Deutschland

Background: In Germany, more than 4.65 million people are currently liv-

ing with a cancer diagnosis. Patients can benet from a healthy lifestyle both

during and aer therapy. In order to provide patients with practical and

scientically based information on health behavior, the authors developed

“Aktiv leben mit Krebs” (ALMIK) using participatory program planning.

Methods: A non-blinded randomized controlled trial with intervention

(IG) and wait list control group (WCG) was conducted at NCT/UCC

Dresden and UCCSH in Kiel in 2022/2023 with a convenience sample of

n=227 patients during and aer therapy (65.7 years ± 11.7, 54.2% male).

IG and WCG received a questionnaire at baseline and aer 1 month.

IG received the ALMIK brochure and a link to the website with videos.

Changes in health literacy (HLS-EU Q) and acceptance were assessed.

Result: Acceptance of ALMIK in IG was high: 94.1% of all n=109 patients

in the IG reported having used the brochure. 40.4% had visited the web-

site. Videos were used by 36.7%. Almost all patients rated the brochure as

understandable (97.8%), relevant (90.3%) and clearly presented (98.9%).

Patients also rated the website as well-structured (95.6%) and attractively

designed (97.6%), and the videos as understandable (93.0%) and relevant

(79.1%). Overall, 97.8% were satised with the program and 98.9% would

recommend it to others. Patients of IG did not achieve higher HLS-score

in comparison to WCG (p=0.75).

Discussion: e brochure was used by many patients and was very well

accepted. e website and videos were used less frequently, but overall

by more than one-third of patients, who were also satised with them.

Health literacy was not increased by ALMIK, which may be due to the low

intervention strength.

Conclusion: e high number of participants who used ALMIK indicates

a high need for health behavior information for cancer patients. Patient

involvement has proven to be an important component in creating well

accepted program materials.

Disclosure Statement: e authors declare no conict of interest.

916

Eects of acute exercise on circulating immune cells in

adolescents and young adults undergoing cancer treatment

Isabella Deppe1,2; Ronja Beller1,2; Fabian Kiehl2,3; Nico de Lazzari2,4;

Sabrina B Bennstein5; Dirk Reinhardt1,2; Uta Dirksen1,2; Miriam Götte2,4

1Pediatric III, West German Cancer Center, University Hospital Essen, University

Duisburg-Essen, Essen, Deutschland

2German Cancer Consortium (DKTK), site Essen, National Center for

Tumordiseases site Essen, University Hospital Essen, Essen, Deutschland

3Department of Palliative Medicine, West German Cancer Center Essen,

University Hospital Essen, Essen, Deutschland

4West German Cancer Center Essen, University Hospital Essen, Essen,

Deutschland

5Institute for Transplantation Diagnostics and Cell Therapeutics, Medical Faculty,

Heinrich-Heine University Düsseldorf, Düsseldorf, Deutschland

Background: ere is evidence, that acute exercise mobilizes immune

cells, particularly natural killer (NK) cells into the circulation of patients

with breast cancer, prostate cancer and lymphomas. Mobilized immune

cells appear to play an important role in the anti-tumor eect. e aim of

this study was to investigate the response of immune cells to high inten-

sity interval training (HIIT) in adolescents and young adults (AYAs) diag-

nosed with cancer.

Methods: 20 AYA cancer patients (25 ± 7 years old) and 20 matched

healthy controls (27 ± 5 years old) completed a 20 minutes of HIIT on a

bicycle ergometer. Heart rate, oxygen saturation, perceived exertion rate,

watt power and adverse events were monitored during exercise. Blood

samples were taken before (T0), aer (T1) the exercise intervention and

aer a one-hour recovery period (T2). NK cells, innate lymphoid cells

(ILCs) and their subgroups were determined by ow cytometry.

Result: e total number of NK cells and ILC’s respectively, their sub-

groups CD56dim NK cells, ILC1-like and ILC2 increased signicantly in

both groups from T0 to T1 and decreased aer the one-hour recovery

period (T2). CD56bright NK cells and ILCP (ILC precursor) changed sig-

nicantly from T0 to T1 and T1 to T2 in the control group but not in the

patient group. e percentage changes in immune cells from T0 to T1 or

T1 to T2 did not dier signicantly between the two groups.

Discussion: e increase in mobilized immune cells could be explained

by their response to epinephrine and ß-adrenergic receptors, whereas an

explanation for decrease in NK cells from T1 to T2 might be the migration

of cells to organs during the recovery phase.

Conclusion: A single bout of HIIT results in increased peripheral blood

mobilization of NK cells and ILCs in AYA cancer patients comparable

to healthy controls. Exercise may therefore play an important role in the

defence against pathogens or neoplastic cells.

Disclosure Statement: e authors declare no conict of interest.

923

Four month of exercise intervention improves balance,

eye-hand-coordination and cardiovascular functioning in a

choroidal melanoma patient: a case report

Michael Mendes Wefelnberg; Ludwig M. Heindl; Alexander Rokohl;

Freerk T. Baumann

Uniklinik Köln, Köln, Deutschland

Authors’ aliations: 1Department 1 of Internal Medicine, Center

for Integrated Oncology Aachen, Bonn, Köln, Düsseldorf, University

Hospital of Köln, Köln, DE

Introduction: Choroidal melanoma is the most common eye cancer with

high overall mortality. Patients frequently suer from severe visual and

functional impairments. Eective supportive therapies are widely lacking.

We studied the ecacy of a four-month clinical exercise program parallel

to radiation and immune therapy on cardio-respiratory tness (CRF) as

well as visual and functional tests (VFT).

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 217

Methods: is prospective intervention case study focuses on a 61-year-

old female patient diagnosed with metastatic choroidal melanoma in

the right eye who was set to undergo Cyberknife radiation and immune

therapy for treatment. Data were collected on ve occasions: baseline

(to), post-Cyberknife (t1), pre- (t2), intermediate (t3) and post-immune

therapy (t4). e response in VFT and CFR to exercise intervention were

examined. We conducted two sessions per week of high-intensity interval

training (HIIT) and visual-coordinative exercises.

Results: Signicant improvements were observed for VFT between t0 and

t4 overcompensating radiotherapy-induced declines in t1. CRF initially

improved and then stabilized under immune therapy. Specically, indi-

vidual progressions in balance and eye-hand coordination (EHC) demon-

strated increments of 133% and 8% respectively. VO2 uptake and peak

power output increased by ~7 mL·kg·min-1 and 30 W respectively up until

t3 and declined by ~3 mL·kg·min-1 and 15 W respectively in t4.

Conclusion: e current case report’s data demonstrated improvements

in balance as well as EHC and stabilized CRF levels under immune ther-

apy. Further research is required to extend these ndings to a larger

choroidal melanoma patient cohort.

Disclosure Statement: e authors declare no conict of interest.

932

Eight weeks of exercise intervention improves visual and

cardiovascular functioning in a choroidal melanoma patient:

a case report

Michael Mendes Wefelnberg; Madeline Moll; Ludwig M. Heindl;

Alexander Rokohl; Damir Zubac; Freerk T. Baumann

Uniklinik Köln, Köln, Deutschland

Authors’ aliations

1Department 1 of Internal Medicine, Center for Integrated Oncology

Aachen, Bonn, Köln, Düsseldorf, University Hospital of Köln, Köln, DE

Introduction: Choroidal melanoma, the most prevalent eye cancer glob-

ally, is highly mortal and frequently leads to sweeping visual and func-

tional impairments. We studied the eects of an 8-week exercise program

on visual and functional tests (VFT), cardiorespiratory tness (CRF) and

microvascular circulation in a moderately active young male.

Methods: is prospective intervention case study focuses on a 29-year-

old male patient diagnosed with choroidal melanoma who was set to

undergo radiation brachytherapy for treatment. Data were collected on

three occasions: baseline, transitional, and nal assessments. VFT, CFR,

and the response of microvascular circulation (evaluated via icker

light-induced dilation, FID) to exercise were examined. e exercise reg-

imen entailed high-intensity interval training (HIIT), coupled with visu-

al-coordinative exercises.

Results: Following an 8-week exercise intervention, signicant improve-

ments were observed in CRF, VFT, and microvascular circulation.

Specically, individual progressions in visu-motor reaction time (VMRT)

and eye-hand coordination (EHC) showed increments of 35.9% and

11.1% respectively. Moreover, V

O2 uptake increased by ~7 mL·kg·min-1,

and peak power output surged by 50 W. Ultimately, the dilation of both

arteries and veins in response to FID stimulus exhibited a twofold increase

compared to baseline levels.

Conclusion: In a focused 8-week program, exercises improved EHC,

VMRT and CRF levels. Interestingly, vascular endothelial function also

improved post-exercise. Further research is required to extend these nd-

ings to a larger choroidal melanoma patient cohort.

Disclosure Statement: e authors declare no conict of interest.

955

Variability in resistance training trajectories of breast cancer

patients undergoing therapy

Maximilian Köppel1; Karen Steindorf2; Martina Schmidt2;

Joachim Wiskemann1

1Nationales Centrum für Tumorerkrankungen – NCT, Heidelberg, Deutschland

2Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Deutschland

Background: Progression in training volume in resistance training (RT)

during the training sessions (TS) over the course of an exercise interven-

tion, is an important indicator of training ecacy. However, as research

has shown, these growth-trajectories can dier substantially between

individuals. A proper understanding of these patterns is crucial for exer-

cise planning, especially in clinical populations. We investigated the varia-

tion of the measured gain in training volume between exercises as well as

between individual patients.

Methods: In total 69 breast cancer patients undergoing adjuvant cancer

treatment from two randomized controlled trails were investigated. ey

conducted 12-weeks of progressive RT. We tted a quadratic Bayesian

regression model to the baseline standardized training volume over the

course of the intervention. We allowed all parameters to vary between

exercises and individuals.

Results: We estimated a positive linear component of 0.093 (95%

Uncertainty interval (UI) 0.058 to 0.120) and a negative quadratic com-

ponent of -0.002 (95% UI -0.008 to 0.001) for the overall change in train-

ing volume per TS. For the dierent exercises we observed a standard

deviation for both the linear (0.043, 95% UI 0.018 to 0.082) and the qua-

dratic component (0.002, 95% UI <0.001 to 0.004). e between-indi-

vidual distribution of the parameters appears to be substantially larger.

Extrapolation of the regression model indicates the trajectory meets a

plateau aer a median of 20.6 TS (95% UI 14.8 to 44.4).

Discussion: We observed large inter-individual variation regarding the

resistance training progression in breast cancer patients undergoing

tumor therapy and a smaller but still relevant variation between dier-

ent exercises. We further observed that the training response will even-

tually plateau.

Conclusion: Exercise therapy in cancer patients might benet from

a more personalized approach regarding training composition. e

non-linear character of the trajectory demands the application of period-

ization schemes.

Disclosure Statement: e authors declare no conict of interest.

Surgical Oncology including Robotics

824

Innovations in Musculoskeletal Surgery -Fluorescence

Imaging Guidance and Photodynamic Therapy in

Orthopaedic-Onocolgy

Frank Traub

Universitätsmedizin Mainz, Mainz, Deutschland

Background: In oncological surgery, primarily CT and MRI is used pre-

operatively to determine tumor boundaries and to plan the resection.

ese imaging methods can only be used in real-time in the operating

theatre to a very limited extent and have limited tumor specicity.

Photodynamic therapy (PDT) and uorescence imaging are two inno-

vative techniques that have signicantly impacted the eld of oncol-

ogy surgery. ey oer valuable tools for both diagnosis and treatment,

enhancing the precision and eectiveness of surgical procedures.

Methods: Fluorescence imaging and Photodynamic therapy are a mini-

mally invasive techniques using dyes light to selectively target and destroy

cancerous cells.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts218

e possibilities and the results of PDT and Fl are to be shown on the basis

of our own laboratory tests and examples from clinical use.

Result: Apoptosis could be induced especially in bone metastases of

breast carcinomas. In bone metastases of renal carcinomas, senescence

was induced but not apoptosis. In so tissue sarcomas, the results were

very diverse. us, induction of apoptosis was seen in leiomyosarcomas

and desmoid tumours.

FI guided resection showed very good results. In particular, in angio-

sarcomas. Also in some other STS tumor extensions could be identied

intraoperatively and thus a histological R0 resection could be performed.

Discussion: So tissue sarcomas and Bone metastasis have dierent sensi-

tivity to the exposure of 5-ALA PDT, resulting in cell fate apoptosis or senes-

cence, depending on the extent of the cellular damage. We found that PDT

has potential applicability in bone metastases of invasive ductal carcinoma

and in Leiomyosarcoma and Desmoid tumors. Intraoperative FI resection

has shown to be a valuable tool in order to reach negative resection margins.

Conclusion: ese techniques contribute to more precise and eective

surgeries, leading to better patient outcomes and potentially reducing the

need for follow-up interventions.

Disclosure Statement: e authors declare no conict of interest.

Thoracic Cancer

574

Tumor Treating Fields (TTFields) In GEneral Routine clinical

care in patients with pleural mesothelioma (TIGER Meso)

Martin Metzenmacher1; Christian Grohé2; Till Plönes3; Federica Grosso4;

Giovanni Ceresoli5

1Universitätsklinikum Essen, Essen, Deutschland

2Johannesstift Diakonie, Berlin, Deutschland

3Fachkrankenhaus Coswig, Coswig, Deutschland

4Ospedale Alessandria, Alessandria, Italien

5Humanitas Gavazzeni, Bergamo, Italien

Background: Pleural mesothelioma (PM) is a rare cancer that is com-

monly associated with asbestos exposure. Due to its diuse and distinct

dispersion in the pleura, an R0 resection is hard and the prognosis bad.

Recently, checkpoint inhibitors showed an extension of overall survival

(OS) in unresectable PM, but a high unmet medical need for eective

treatment remains. Tumor Treating Fields (TTFields) are low-intensity,

intermediate frequency alternating electric elds that inhibit cancer

cell division. In a phase 2 study (STELLAR), adding TTFields to peme-

trexed plus cisplatin or carboplatin yielded encouraging results regarding

median OS and progression-free survival. ere is interest among pre-

scribing physicians to validate these results in routine clinical care. e

aim of this study is to evaluate safety and ecacy of TTFields in routine

clinical care of PM, as well as changes in quality of life (QoL), treatment

duration and device usage.

Methods: e TIGER Meso study is a non-interventional, observational,

prospective study to be conducted in Germany, Italy and the Netherlands

(NCT05538806). Patients with PM without an option of curative resection

who are eligible for TTFields therapy will be asked for consent for study

participation. TTFields will be delivered non-invasively and locoregion-

ally at a frequency of 150kHz by placing transducer arrays connected to

a portable medical device on the thorax. At baseline and months 3 and 6

aer treatment start, demographic data and QoL (EQ-5D-5L, QLQ-LC13,

and LCSS-Meso questionnaires) will be assessed. For the remaining end-

points, follow-up visits will be scheduled every 2-4 months in line with

routine clinical care recommendations. e planned number of patients is

about 200 with a follow-up period of 18 months.

Results: e TIGER Meso study is currently enrolling patients.

Conclusion: e TIGER Meso study will generate prospective data for

the use of TTFields in routine clinical care of PM. e study supports

the evaluation of treatment-related data, which could play a role in future

assessment of treatment duration and usage.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

756

PET-CT detects response to treatment with ipilimumab and

nivolumab in malignant mesothelioma better than CT

Daniel Christoph1; Martin Metzenmacher2; Servet Bölükbas2;

Jan Volmerig1; Georg Nilius1; Prof. Dr. Detlef Moka3; Hubertus Hautzel2

1Evang. Kliniken Essen-Mitte, Essen, Deutschland

2Universitätsklinikum Essen, Essen, Deutschland

3Zentrum für Nuklearmedizin Essen, Essen, Deutschland

Background: Ipilimumab and nivolumab are used as rst-line treat-

ment or patients (pts) with unresectable malignant mesothelioma (MM).

Response assessment by CT using modied RECIST might miss detection

of response. PET-CT based assessment might recognize more pts benet-

ting from this therapy.

Methods: A retrospective analysis of pts with unresectable MM receiving

rst-line ipilimumab and nivolumab was performed. Pts got a baseline

PET-CT scan to clarify resectability before the start of systemic therapy.

Scans were repeated aer every 12 weeks of treatment. ORR was calcu-

lated by using RECIST v1.1, mRECIST, PERCISTSULpeak and PERCISTMTV

were used separately to categorize responders.

Results: 30 pts (22 male (73.3%) and 8 female (26.7%) received a baseline

PET-CT and underwent therapy with ipilimumab (1 mg/kg, d1, q6w) and

nivolumab (360 mg abs., d1+22, q6w). Regarding histology, 18 pts (60%) suf-

fered from epithelioid, 4 pts (13.3%) from sarcomatoid and 8 pts (26.7%)

from biphasic mesothelioma. Origin of the mesothelioma were pleura in

25 pts (83.3%) and peritoneum in 5 pts (16.7%). Due to clinical progres-

sion and/or adverse events, a follow-up PET-CT was performed only in

21 pts (70%), while 3 pts have recently started therapy. In 2 pts CT scan

showed progressive disease. Both pts continued treatment due to metabolic

response detected in PET-CT scans. Another patient showed progression

aer 2 cycles, continued therapy due to clinical benet and responded well

aer 4 cycles (pseudo-progression). According to follow-up PET-CT scans,

10 pts responded (45.5%), 8 pts achieved disease stabilization (36.4%) and

4 pts showed progression (18.1%). Median PFS was 8.5 months, median OS

was 21.2 months. Detailed response assessment with RECIST v1.1, mRE-

CIST, PERCISTSULpeak and PERCISTMTV will be reported at the meeting.

Discussion: During therapy with ipilimumab and nivolumab, more pts

showed metabolic compared to morphological responses.

Conclusion: PET-CT scans based response assessment identies MM pts

responding to ipilimumab and nivolumab better than CT scans.

Disclosure Statement: e authors declare the following: COIs werden in der

Präsentation bzw.im Poster aufgelistet.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 219

Translational Oncology

A best practice model for optimizing medication safety

withoral antitumor therapy: Implementation of the AMBORA

care program in real-world clinical routine

Lisa Cuba1,2,3; Katja Schlichtig2,3; Pauline Dürr1,2,3; Martin F. Fromm2,3;

Frank Dörje1,3

1Pharmacy Department, Erlangen University Hospital, Erlangen, Deutschland

2Institute of Experimental and Clinical Pharmacology and Toxicology, Friedrich-

Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Deutschland

3Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital,

Erlangen, Deutschland

Background: e randomized AMBORA trial1 (Medication Safety with

Oral Antitumor erapy) reported considerable benets of a clinical phar-

macological/pharmaceutical care program for patients treated with oral

antitumor therapeutics (e.g., reduction of severe side eects). However,

generating evidence for the ecacy of an intervention is not sucient to

bridge the gap between research and practice.

Methods: e AMBORA Center investigates the translation of this evi-

dence-based program (including e.g., patient consultations, a counseling

service, and training events) into routine care. We follow the RE-AIM

framework to analyze implementation outcomes while assessing its clin-

ical eectiveness in real-world. Qualitative data gathered by semi-struc-

tured stakeholder interviews and surveys among patients and physicians

is used to evaluate the implementation process. ereby, we aim to derive

a best practice model.

Result: Within two years, 304 councils were conducted and 420 patients

were referred to the AMBORA Center by 15 clinical units within 7 dif-

ferent institutions. A quantitative assessment of patient recruitment and

prescription data is complemented by qualitative aspects. Stakeholder

interviews and surveys identied implementation barriers and facilitators

(e.g., inner organizational structures) to derive tailored recommendations.

Discussion: Real-world conditions in heterogenous structures place high

demands on the adaptability of new care programs. Multilevel implemen-

tation strategies are necessary to enhance and maintain outreach. e

high degree of acceptance among patients and treatment teams substanti-

ates the tremendous need for a sustainable implementation of the services

provided by the AMBORA Center.

Conclusion: Based on a comprehensive evaluation of the implementation

process, we derived a best practice model of how to optimize medica-

tion safety with oral antitumor therapy in real-world clinical routine and

provide recommendations for the dissemination of the AMBORA care

program to other cancer centers.

1 Dürr et al. JCO 2021.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

239

Establishment and implementation of a multi-site Molecular

Tumor Board (MTB) at the Center for Integrated Oncology

Aachen Bonn Cologne Düsseldorf (CIOABCD)

Selina Hahn1; Lisa Fischer1; Marcel Bourgeois2,3; Lena Häberle4,5;

Georg Feldmann6,7; Udo Siebolts1,8; Martin Kirschner2,3; Verena Tischler7,9;

Simon Labuhn5,10; Wolfgang Göring4,5; Anika Schablack1;

Nadina Ortiz-Brüchle3,11; Matthias Scheer1,12

1CIO Cologne, University Hospital of Cologne, Center for Integrated Oncology

Aachen Bonn Cologne Duesseldorf (CIO ABCD), Cologne, Deutschland

2Department of Hematology, Oncology, Hemostaseology and Stem Cell

Transplantation, Medical Faculty, RWTH Aachen University, Aachen,

Deutschland

3CIO Aachen, University Hospital RWTH Aachen, Center for Integrated Oncology

Aachen Bonn Cologne Duesseldorf (CIO ABCD), Aachen, Deutschland

4Institute of Pathology, Heinrich Heine University & University Hospital

Düsseldorf, Düsseldorf, Deutschland

5CIO Düsseldorf, Heinrich Heine University & University Hospital Düsseldorf,

Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD),

Düsseldorf, Deutschland

6Department III for Internal Medicine, University Hospital Bonn, Bonn,

Deutschland

7CIO Bonn, University Hospital Bonn, Center for Integrated Oncology Aachen

Bonn Cologne Duesseldorf (CIO ABCD), Bonn, Deutschland

8Institute of Pathology, University Hospital of Cologne, Cologne, Deutschland,

9Institute of Pathology, University Hospital Bonn, Bonn, Deutschland

10Department of Gastroenterology, Hepatology and Infectious Diseases,

Heinrich Heine University & University Hospital Düsseldorf, Düsseldorf,

Deutschland

11Institute of Pathology, University Hospital RWTH Aachen, Aachen,

Deutschland

12Department I for Internal Medicine, University Hospital of Cologne,

Cologne, Deutschland

Background: e concept of cancer as a genomic disease has paved the

way for targeted cancer therapy. With the growing knowledge of can-

cer aberrations and the accessibility of parallel sequencing approaches,

molecular tumor boards (MTBs) have become central tools in modern

patient care. We demonstrate the feasibility of implementing and running

a multi-site MTB of the CCC CIOABCD, which consists of the university

hospitals of Aachen, Bonn, Cologne and Düsseldorf.

Methods: As all participants also run local MTBs, cases were selected

where additional discussion was deemed useful and where genomic data

was available. A “virtual” nature of the CIO MTBABCD is necessary to

overcome the geographic barriers between the four sites. Meetings were

held every two weeks. Written informed consent was obtained from all

patients.

Results: To date, 73 CIO MTBABCD have been held, with an average of

20 experts discussing the cases. In addition to oncologists, (molecular)

pathologists and molecular biologists, human geneticists, bioinforma-

ticians, organ-specic experts, and, on demand, radiologists or neu-

ropathologists participated in 100% of the CIO MTBsABCD, under the

supervision of a coordinator, due to complexity. In total, more than 1000

molecular annotated patients were presented and discussed in local MTBs

and joined CIO MTBABCD. e most frequently discussed tumor entities

were lung (25%), colorectal (15%), and head and neck cancer (10%). In

2022 a recommendation based on the molecular aberrations discussed

was given in 53%, and participation in a clinical trial was given in 37%.

In addition to the contributing centers, 51% of patients were enrolled

through collaborating regional partners by August 2023.

Discussion: e workow between the four institutions is optimized. e

CIO MTBABCD is up and running. A joined MTB registry of all four sites is

currently under construction.

Conclusion: We have established the CIO MTBABCD as a collaborative tool

and network for knowledge ow between academic centers, primary care

practices, and hospitals.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts220

305

Unraveling causes of drug resistance in BRAFV600ECRC using

single-cell mRNA sequencing of preclinical models

Anna Kotarac1,2,3,4; Lara Kunhardt von Schmidt1,4; Alexander Malt5;

Alexandra Trinks6; Hiroki Osumi7; Annalisa Lorenzato8;

Federica DI Nicolantonio8,9; Mariangela Russo8; Ryoji Yao10;

Naveed Ishaque5; Markus Morkel2,3,11,12; Alberto Bardelli8,13;

Ulrich Keilholz1,2,3; Christine Sers2,3,12; Sebastian Stintzing2,3,4;

Loredana Vecchione1,2,3,4,14

1Charité Comprehensive Cancer Center, Berlin, Deutschland

2German Cancer Consortium, Berlin, Deutschland

3German Cancer Research Center, Heidelberg, Deutschland

4Department of Hematology, Oncology, and Cancer Immunology, Campus

Charité Mitte, Charité Universitätsmedizin Berlin, Berlin, Deutschland

5BIH Center for Digital Health, Computational Oncology, Berlin Institute of

Health (BIH), Berlin, Deutschland

6Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Bioportal Single

Cells, Berlin, Deutschland

7Department of Gastroenterological Chemotherapy, Cancer Institute Hospital,

Japanese Foundation for Cancer Research, Tokyo, Japan

8Department of Oncology, University of Turin, Turin, Italien

9Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italien

10Department of Cell Biology, Cancer Institute, Japanese Foundation for Cancer

Research, Tokyo, Japan

11Berlin Institute of Health at Charité Universitätsmedizin Berlin, Bioportal Single

Cells, Berlin, Deutschland

12Department of Pathology, Charité Universitätsmedizin Berlin, Berlin,

Deutschland

13IFOM ETS, The AIRC Institute of Molecular Oncology, Milan, Italien

14Berlin Institute of Health at Charité Universitätsmedizin Berlin,BIH Biomedical

Innovation Academy, BIH Charité (Junior) (Digital) Clinician Scientist Program,

Berlin, Deutschland

Background: Chemotherapy remains the mainstay of palliative treat-

ments for BRAFV600E metastatic colorectal cancer, with limited ecacy

(1). Despite the approval of a new chemo-free regimen aer systematic

therapy, response is still poor, thus highlighting an unmet clinical need

(2,3). erefore, we aim to use single-cell mRNA sequencing (scRNAseq)

to identify transcriptional subpopulations as biomarkers of resistance to

conventional therapy.

Methods: Nine BRAFV600E CRC cell lines and ten BRAFV600E CRC

patient-derived organoids (PDOs) are being treated with the following

drugs in short term proliferation assays: erlotinib (OSI-744), encorafenib

(LGX818), 5-urouracil (5-FU), irinotecan (SN-38), oxaliplatin (L-OHP),

OSI-744+LGX818, OSI-744+SN-38, 5-FU+SN-38, 5-FU+L-OHP,

5-FU+SN-38+L-OHP. Sensitivity is being dened by IC50, AUC and

Synergy Score. Aer isolation, cell lines and PDOs at baseline and aer

treatment are being subjected to barcoding, library preparation and

sequencing (Illumina NovaSeq, 1600 mio. reads per library).

Results: Four out of ten PDO models are sensitive to OSI-744+LGX818

and one out of ten is sensitive to SN38+OSI-744. While HT29 CRC cell

line is resistant to OSI-744+LGX818, 5-FU+L-OHP, 5-FU+SN-38 and

5-FU+SN-38+L-OHP, KM20 and WiDr CRC cell lines are sensitive

to these combinations. Further drug testing in remaining models and

scRNAseq is currently ongoing. e integration of response data and

scRNAseq analysis will be validated in publicly available and in-house

clinical data sets.

Discussion: So far variable responses to drug testing have been observed.

ScRNAseq will help to identify genomic determinants of BRAFV600E heter-

ogeneity and resistance to conventional therapies.

Conclusion: To the best of our knowledge, this is the rst preclinical study

using BRAFV600E CRC preclinical models, aiming at identifying mecha-

nisms of resistance to conventional treatment currently used in clinical

practice by scRNAseq technology.

1 Kuipers et al., PMID: 27189416.

2 Tabernero et al., PMID: 33503393.

3 Middleton et al., PMID: 32047001.

Disclosure Statement: e authors declare the following: LV received research

funding and travel bursaries from Pierre Fabre.

311

German Radiation Oncology‘s Next Generation: A web-based

Survey of Young Biologists, Medical Physicists, and Physicians

Lisa Deloch1,2,3,4; Thomas Weissmann1,3,4; Johann Matschke5;

Sarah Stefanowicz4,6; Maximilian Grohmann4,7; Felix Ehret4,8;

Alexander Fabian4,9; Alexander Rühle4,10,11; Simone Wegen4,12;

Sebastian Lettmaier1,3; Maike Trommer4,13,14; Elena Sperk15;

Annemarie Schröder4,16

1Department of Radiation Oncology, Universitätsklinikum Erlangen,

Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Deutschland

2Translational Radiationbiology, Department of Radiation Oncology,

Universitätsklinikum Erlangen, Friedrich-Alexander-Universität

Erlangen-Nürnberg, Erlangen, Deutschland

3Comprehensive Cancer Center Erlangen-EMN, Erlangen, Deutschland

4Young DEGRO Trial Group, Berlin, Deutschland

5Institute of Cell Biology (Cancer Research), University Hospital Essen, University

of Duisburg-Essen, Essen, Deutschland

6Department of Radiation Oncology, Klinikum rechts der Isar, Technical

University of Munich (TUM), München, Deutschland

7Department of Radiotherapy and Radiation Oncology, University Medical

Center Hamburg-Eppendorf, Hamburg, Deutschland

8Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität

Berlin and Humboldt-Universität zu Berlin, Department of Radiation Oncology,

Berlin, Deutschland

9Klinik für Strahlentherapie, Universitätsklinikum Schleswig-Holstein, Kiel,

Deutschland

10Department of Radiation Oncology, University of Freiburg – Medical Center,

Freiburg, Deutschland

11Department of Radiation Oncology, University of Leipzig, Leipzig, Deutschland

12Department of Radiation Oncology, Cyberknife and Radiotherapy, Faculty of

Medicine and University Hospital Cologne, Köln, Deutschland

13Department of Radiation Oncology, University of Cologne, Faculty of Medicine

and University Hospital Cologne, Köln, Deutschland

14Department of Radiation Oncology, Olivia Newton-John Cancer Wellness &

Research Centre, Austin Health, Melbourne, VIC, Melbourne, Australien

15Mannheim Cancer Center, Universitätsmedizin Mannheim, Medizinische

Fakultät Mannheim, Universität Heidelberg, Mannheim, Deutschland

16Department of Radiotherapy and Radiation Oncology, University Medical

Center Rostock, Rostock, Deutschland

Background: e eld of radiation oncology (RO) is a close interconnec-

tion of multiple disciplines and has undergone a signicant change due to

new diagnostic and therapeutic developments that have revolutionized the

eld. A close, constructive collaboration of physicians, medical physicists,

and biologists is required to ensure existing and future-oriented standards.

However, during day-to-day work, the impression of a negative trend within

the workforce in RO arises, as young scientists seem to leave the eld quickly

despite active oers for career support from the (young) German scientic

organizations. Reasons for a career change may be multifactorial. We thus

aim to capture the current situation of all scientic disciplines in RO as we

intend to not only gain insight into the needs and problems of young scien-

tists but also to identify measures that can be taken for a positive turnaround

to foster a future-oriented and high-quality scientic culture in Germany.

Methods: Over a period of 6 weeks, a web-based survey was conducted

by the Trial Group from the youngDEGRO (Deutsche Gesellscha für

Radioonkologie) with members of the yDeGBS (Deutsche Gesellscha

für Biologische Strahlenforschung) and yMP (Deutsche Gesellscha für

Medizinische Physik) which included 13 generalized and 20-25 occupa-

tion-specic questions.

Results: e 218 questionnaires were completed by 89 physicians, 59 biol-

ogists, and 70 physicists. While overall satisfaction in the workforce seems

to be rather high, and the majority of participants would choose the same

career path again, several factors contribute to a decline in employee satis-

faction. Although university hospitals appear to be an attractive employer,

factors such as assurance of protected research time, especially for physi-

cians, will have to be addressed.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 221

Conclusion: A large interest in a close interdisciplinary collaboration is

evident, opening up opportunities for intensied, high-quality transla-

tional research and joint eorts to maintain and expand future compe-

tence within RO in Germany.

LD, TW contributed equally

Disclosure Statement: e authors declare the following: LD, Supported by the

BMBF (TOGETHER, 02NUK073; GREWIS, 02NUK017G, GREWIS-alpha,

02NUK050E); JM, Supported by the BMBF (02NUK061B), MT, Supported by the

Koeln Fortune Program / Faculty of Medicine, University of Cologne.

331

Breite Onkologische Versorgung im digitalen Kreislauf der

Wissen generierenden Versorgung

Wolfgang Knauf; Thomas Illmer; Nils Dreiack; Jana Becker;

Armin Goetzenich

Berufsverband der niedergelassenen Ärztinnen und Ärzte für Hämatologie und

Medizinische Onkologie (BNHO e.V), Köln, Deutschland

At the inception of knowledge-driven care in the outpatient sector,

molecular diagnostics play a pivotal role within a structured framework.

Recent advancements in this eld have signicantly improved the accu-

racy of describing oncological conditions. is marks the initiation of

a reciprocal cycle between healthcare delivery and research, poised to

yield substantial progress in tumor patients survival and disease manage-

ment through targeted applications in the forthcoming years. Enhancing

cross-sectoral oncological standard care necessitates seamless collabora-

tion among regional and supra-regional care structures, including onco-

logical centers, organ cancer centers, certied hospitals, local hospitals,

general practitioners, practicing oncology specialists, nursing services,

patient representatives, and the patients themselves. e primary goal of

this approach is to provide cancer patients with access to modern molec-

ular diagnostics while also utilizing the acquired data as a foundation for

further oncological research. Furthermore, the approach aims to be inte-

grated as a structured system within the healthcare framework:

Patient Access: Ensuring cancer patients access to quality-assured and

certied NGS or WGS diagnostics, primarily carried out in CCC or within

the network centers of nNGM.

MTB: Convened when decisions cannot be made based on available

guideline recommendations. e interpretation of molecular ndings and

proles of individual diseases necessitates collaboration among specialists

from various disciplines.

Databases and Evaluation: Establishing databases that systematically

document patient core data, medical history, diagnosis, tumor histology,

molecular diagnostic data, treatment, and progression data (DigiNet)

PRO: Collecting PRO data for comprehensive evaluation of process and

outcome quality, addressing patient-specic inquiries.

Research Integration: Providing information and recommendations

derived from research studies, complementing the evidence-based ther-

apeutic recommendations of MTBs.

Disclosure Statement: e authors declare no conict of interest.

433

NMR-based GFR measurement in patients on high-dose

methotrexate

Sabine Einhell1; Amauri Schwäble Santamaria2; Andrew Robertson2;

Marcello Grassi2; Tobias Pukrop1; Eric Schier2

1Universitätsklinikum Regensburg, Regensburg, Deutschland

2Numares AG, Regensburg, Deutschland

Background: In the context of hemato-oncological therapies, nephro-

toxic drugs such as methotrexate (MTX) play an important role. Since

its delayed excretion can lead to severe side eects, close monitoring with

surveillance of renal function is necessary. In clinical practice, this is done

by determining eGFR by creatinine, which, however, is of limited use in

oncological and elderly patients due to reduced muscle mass/sarcopenia.

For this reason, an alternative GFR determination via NMR measurement

was investigated in this work in collaboration with the numares AG.

Methods: To date, 29/30 patients with acute lymphoblastic leukemia or

(CNS-) lymphoma who received high-dose MTX as part of their guide-

line-guided therapy have been included. Serum was obtained at 4 dierent

time points -before MTX-, 24, 42 and 48 h aer the start of MTX admin-

istration-, measured by NMR in 5-fold replicates and compared with the

commonly used GFR measurements eGFRCr (CKD-EPI (Chronic Kidney

Disease Epidemiology Collaboration) creatinine) and eGFRCrCys (CKD-

EPI creatinine cystatin).

Result: Initial analysis (9 patients, 13 cycles) showed that NMR meas-

urements were not aected by MTX. During the course of MTX applica-

tions, a 1.5- to 2-fold increase in creatinine was detected in 1 patient aer

eGFRCr according to AKIN criteria (stage 1). eGFRNMR best reected MTX

plasma clearance with r=0.758 (95% CI 0.36-0.92, p=0.004) compared

to CKD-EPICr (r=0.401, 95%CI -0.19-0.78, p=0.176) and CKD-EPICrCyc

(r=0.632, 95% CI 0.12-0.88).

Discussion: e dose reductions of drugs frequently required in clinical

practice due to impaired renal function aect patient response to therapy

and survival. More precise estimation of GFR may allow better individu-

alization for each patient.

Conclusion: In the context of MTX therapies, monitoring of GFR is

possible via NMR technique, which, compared to conventional methods,

better reects MTX clearance.

Indication of source: AACC 2023 Poster.

Disclosure Statement: e authors declare no conict of interest.

468

Advancing Precision Oncology: Integration of Onco-PDO Test

for Rapid Drug Response Proling in Breast Cancer

Patient-Derived Organoids

Zahra Dantes1; Jolanta Slawska1; Apoorva Manjunath1;

Sandra Zormaier1; Anja Steininger1; Florian Mandlmeier1;

Luciana Ferreira1; Linda Huang2; Katja Steiger3; Nicole Pfarr3;

Marion Kiechle4; Kathrin Lindner1; Wilko Weichert3; Christian Peschel5;

Stefan Paepke4

1Invitrocue Europe AG, München, Deutschland

2Invitrocue Hong Kong Ltd, Hong Kong SAR, China, VR

3Institue of Pathology, Technical University of Munich (TUM), München,

Deutschland

4Department of Gynecology, Technical University of Munich (TUM), München,

Deutschland

5Technical University of Munich (TUM), München, Deutschland

Background: Since patient-derived organoids (PDOs) can potentially

serve as a preeminent model for precision oncology, we aimed to con-

duct a prospective exploratory study to generate PDOs from dierent

subtypes of breast cancer (BC) patients for further characterization and

drug screening.

Methods: Aer PDO generation, expansion, and biobanking, PDOs were

compared with matched primary tumor tissue histologically and genom-

ically. Furthermore, the Onco-PDO test, an established drug screening

assay by Invitrocue, was performed in a clinically meaningful timeframe

of 10-14 days to assess PDO drug response. e clinical correlation anal-

ysis between the patient’s response and the matched PDO drug response

is ongoing.

Result: us far, 91 tumor tissues from the primary tumor (PT; N=68) and

lymph node metastases (LN; N=23) were collected from 77 BC patients

enrolled in our study in the Invitrocue Munich laboratory. irteen sam-

ples were taken from PT and matched LN metastasis. e PDOs were

successfully generated from 82 samples and established in 67 cases (suc-

cess rate: 90.1% and 81.7%, respectively). e Onco-PDO test, including

standard-of-care chemotherapeutics, molecular targeted drugs, CDK4/6

inhibitors, and hormone therapy in 67 samples (PT: 55, LN: 12), resulted

in 1191 readouts with high heterogeneity. Genetically and histopathologi-

cally, PDOs showed strong similarities to primary tumors.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts222

Discussion: e Onco-PDO drug testing, encompassing a comprehensive

panel of therapeutics, revealed substantial drug response diversity among

PDOs. is heterogeneity signies the intricacies of individual patient

responses, which can have profound implications for personalized treat-

ment strategies.

Conclusion: Our ndings indicate that BC-PDOs can be generated from

a small biopsy, and the Onco-PDO drug testing can be performed in a

clinically meaningful timeline of <14 days to identify the responder and

non-responder PDOs towards each treatment and potentially minimize

side eects from unnecessary treatments and may allow a better predic-

tion of tumor response.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

531

Optimizing generation of patient derived cancer organoids

for informed clinical decision making

Yazid J. Resheq1; Johann Gout2; Jessica Lindenmayer3; Mark Hänle1;

Thomas J. Ettrich1; Lukas Perkhofer1,2; Thomas Seuerlein1;

Alexander Kleger1,2,3

1Klinik für Innere Medizin I, Universitätsklinikum Ulm, Ulm, Deutschland

2Institut für Molekulare Onkologie und Stammzellbiologie, Universitätsklinikum

Ulm, Ulm, Deutschland

3Core Facility Organoids, Universität Ulm, Ulm, Deutschland

Background: Patient derived organoids (PDOs) are likely to advance per-

sonalized oncology as they recapitulate patient-individual tumors, incl.

pancreatic cancer (PC). For this purpose, reliable reproducibility, time-,

labor- and cost-ecient procedures are required.

Methods: roughout implementation of the Core Facility Organoids

at Ulm University, we established advanced culture techniques/proto-

cols optimized for automation and standardization (i.e. pipetting robot,

downscaling to a 384-well culture system). Additionally, we downscaled

the number of cells required for pharmacotyping. To assess tumor evolu-

tion, longitudinally obtained PDO-pairs from 7 patients were analyzed by

whole exome sequencing (WES).

Results: Automation-optimized culture techniques accelerated

patient-individual phamacotyping from a “hands-on” median of 52 days

to 33 days. By adapting and standardizing of earlier protocols we achieved

an improved rate of PC-PDOs eligible for pharmacotyping from 52% to

80%. We observed a correct correlation of PDO-drug-response and clin-

ical outcome in 86% of treatment-naïve PC-patients also translating into

longer PFS in case of correct prediction of sensitivity in the PDO-culture

to a certain regimen. However, correct correlation decreased to 57% in

PDOs established from pretreated patients. On WES we observed a lower

mutational burden and amount of nonsynonymous mutations following

chemotherapy. Of note, we identied a CHEK2-mutated patient featuring

long-term response to a PARP inhibitor.

Discussion: Due to structured, automated, and standardized processes

in our Core Facility we advanced our PDO-assays to potentially translate

into a prediction tool to guide treatment for distinct patient cohorts.

Conclusion: PDOs may be employed to guide personalized treatment in

a standardized and comprehensive facility. Nevertheless, several achieve-

ments are required for clinical applicability such as bio-printed 3D-models

and prospective clinical trials to prove validity.

Disclosure Statement: e authors declare no conict of interest.

590

Functional role of tumor-specic B cells and tertiary-lymphoid

structures in preclinical models of immune checkpoint

therapy

Jonas Lehmann1; Martin Thelen1; Maria Garcia-Marquez1;

Pauline Volkmar1; Klara Siepmann1; Therese Seidlitz2; Daniel Stange2;

Philipp Fervers3; Thorsten Persigehl3; Christiane J. Bruns4; Michael von

Bergwelt-Baildon5; Kerstin Wennhold1; Hans Schlößer1,4

1Center for Molecular Medicine Cologne (CMMC), Köln, Deutschland

2Universitätsklinikum Carl Gustav Carus Dresden, Dresden, Deutschland

3Uniklinik Köln, Radiology, Cologne, Cologne, Deutschland

4Uniklinik Köln, Department of General, Visceral, Cancer and Transplantation

Surgery, Cologne, Deutschland

5LMU München, Department of Internal Medicine III, Munich, Deutschland

Background: Immune checkpoint inhibition (CKI) demonstrated break-

through therapeutic ecacy in a variety of cancer types. Recent data

suggest an important role of B cells and tertiary-lymphoid structures for

susceptibility of cancer patients to CKI.

Methods: To advance our understanding of B cell specic mechanisms

in the setting of CKI, we used two genetically modied mouse models,

which express a tamoxifen-inducible Cre-recombinase in the stomach-spe-

cic Anxa10 locus. e genomically stable (GS) cancer model (Cdh1/,

KrasG12D/+ and Smad4/) demonstrates a slow progressing tumor growth as

observed by magnetic resonance imaging (MRI). e chromosomally insta-

ble (CIN) model (KrasG12D/+, Tp53R172H/+ and Smad4/f) shows a more rapid,

intestinal tumor growth. For study of antigen-specic immune responses,

we included the subcutaneous PancO2-OVA tumor model. All three mouse

models received single or combination CKI with anti-PD-1 and anti-4-1BB.

Result: CKI in the PancO2-OVA model resulted in a signicant increase

of OVA-specic B cells and secretion of OVA-specic antibodies. is

was accompanied by an increase of Tfollicular helper cells and activated

CD86+ B cells. e genetically modied cancer models developed metas-

tases in liver, lymph nodes and lungs at later stages. We detected B-cell

clusters in the tumor microenvironment indicating the presence of ter-

tiary-lymphoid structures. In the GS model, combination therapy with

anti-PD1 and anti-4-1BB did not result in a signicant reduction of tumor

growth. However, we observed increased percentages of memory B cells,

germinal center B cells, activated CD86+ B cells and activated T-cell sub-

populations. Results of the CIN model will be presented as well.

Discussion: TLS are usually not observed in cancer mouse models, thus

the here described gastric cancer models oer a unique opportunity to

study TLS formation. CKI seems to increase the anti-tumor B-cell response

by enhanced antigen presentation and humoral-immune response.

Conclusion: Our results underline the role of B cells in CKI.

Disclosure Statement: e authors declare no conict of interest.

600

Humanized mouse models for the preclinical evaluation of

novel immune cell therapies, check point inhibitors, and

immune cell engagers

Maria Stecklum1; Annika Wulf-Goldenberg1; Joshua Alcaniz1;

Bernadette Brzezicha1; Walther Wolfgang1,2; Jens Homann1

1EPO GmbH, Berlin, Deutschland

2ECRC, Charité Universitätsmedizin Berlin, Berlin, Deutschland

Background: e preclinical evaluation of novel immune therapies

requires humanized mouse models with functional human immune cells.

In previous studies we have demonstrated, that either peripheral blood

mononuclear cells (PBMC), subsets of PBMCs like T- and NK-cells

or hematopoietic stem cells (HSC) can be used to establish a human-

ized immune system. By transplantation of cell-line-derived (CDX) or

patient-derived (PDX) tumors on humanized mice, we successfully gener-

ated a full human tumor-immune-cell model for dierent disease entities.

Finally, we validated the functionality of these models using checkpoint

inhibitors (CPI) like Nivolumab, and immune cell engagers (ICE).

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 223

Methods: HSC-humanized mice were generated by i.v. transplantation of

HSC to 1st and 2nd generation NOG mice. Engrament of immune cells

was monitored by FACS analysis of blood samples. PBMC or isolated T-

or NK-cell preparations were used to humanize mice by single or mul-

tiple i.v. injections. CDX and PDX from dierent entities were s.c.(i.e.

lymphoma) and/or i.v.(leukemia) transplanted on those humanized mice.

Tumor growth of i.v. models was followed up by BLI measurement.

Results: e transplanted HSCs engraed in mice and established a func-

tional human immune system. e 2nd generation NOG mice are show-

ing an increased total engrament and lineage specic dierentiation.

e selected CDX and PDX tumors successfully engraed on humanized

mice without signicant dierences in tumor growth compared to non-

humanized mice. CPI treatments induced tumor growth delay in selected

models. BLI is a suitable method to follow up systemic disease models and

treatment eects over time.

Conclusions: We established human tumor-immune-cell models of dif-

ferent entities using CDX or PDX in combination with dierent immune

cell subsets. ese models have been successfully used for preclinical eval-

uation of novel CPI, cell therapies and ICE. Our models allow preclinical

translational research on tumor immune biology as well as evaluation of

new therapies, drug combinations and biomarker identication.

Disclosure Statement: e authors declare the following: Angestellter, CSO oder

CEO von EPO GmbH.

732

Exploiting somatic oncogenic driver alterations in a patient

with Li-Fraumeni-Syndrome – Paving the path towards

precision medicine

Carolin Seeling1; Sonja Dahlum2; Ralf Marienfeld3; Vera Hallebach2;

Brigitte Rack4; Uwe Gerstenmaier3; Ambros Beer5;

Regine Mayer-Steinacker1; Wolfgang M. Thaiss5; Thomas Barth3;

Thomas Seuerlein6; Nadine T. Gaisa3; Stephan Stilgenbauer1;

Wolfgang Janni4; Hartmut Döhner1; Reiner Siebert2; Verena Gaidzik1

1Klinik für Innere Medizin III, Universitätsklinikum Ulm, Ulm, Deutschland

2Institut für Humangenetik, Universitätsklinikum Ulm, Ulm, Deutschland

3Institut für Pathologie, Universitätsklinikum Ulm, Ulm, Deutschland

4Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Ulm,

Ulm, Deutschland

5Klinik für Nuklearmedizin, Universitätsklinikum Ulm, Ulm, Deutschland

6Klinik für Innere Medizin I, Universitätsklinikum Ulm, Ulm, Deutschland

Background: Li-Fraumeni-Syndrome (LFS), resulting from pathogenic

germline TP53 variants, represents an inherited cancer susceptibility dis-

order (CSD). Due to impaired DNA damage repair, conventional cyto-

toxic therapies or radiotherapy contribute to high incidence of treatment

related secondary malignancies in these patients.

Methods: Germline analysis was performed from blood DNA using the

TruRisk-Gene-Panel (Illumina). e OncoScan Assay (Aymetrix) and

TMB-NGS-Panel (Illumina) were implemented to identify somatic muta-

tions in the tumor tissues. Genetic proles were interpreted in our molec-

ular and familial tumor board (MoFa) of the Comprehensive Cancer

Center Ulm to provide individual treatment recommendations.

Result: We report the case of a woman with history of breast cancer and

subsequent osteosarcoma (OS), both tumors treated with surgery and

chemotherapy. Due to the tumor history of the patient, genetic testing

was initiated, which revealed a pathogenic TP53 germline variant. Hence,

chemotherapy for OS was stopped and next generation sequencing as well

as OncoScan copy number variation array analysis of the osteosarcoma

tissue were initiated in our MoFa. A homozygous loss of 9p21, harboring

the CDKN2A gene locus, was identied, providing rationale for a treat-

ment with CDK4/6 inhibitor Palbociclib. Aer 2 years Palbociclib was

terminated with no evidence of disease. One year later ovarian cancer was

diagnosed. OncoScan analysis of this ovarian cancer revealed copy num-

ber loss of the BRCA2 gene locus in 13q and a targeted therapy with the

PARP-inhibitor Olaparib was initiated recently.

Discussion: is case report corroborates that genotoxic therapies should

be avoided whenever feasible to reduce the risk of multiple primary tum-

ors in patients with LFS. e identication of additional somatic driver

mutations in LFS tumors provides the basis for targeted and nongenotoxic

therapies.

Conclusion: Early case evaluation by a multidisciplinary MoFa is critical

to increase the awareness of molecular proling and targeted therapies in

patients with CSDs.

Disclosure Statement: e authors declare no conict of interest.

761

MACC1 is a Novel Prognostic Biomarker in Pseudomyxoma

Peritonei and Induces Migration and Drug Resistancein vitro

Matylda Zoa Kuzinska1,2; Safak Gül-Klein1; Dennis Kobelt2,3;

Viktoria Zinnow2; Pia Herrmann2; Nina Heisterkamp2; Sandra Wegel1;

Annette Torgunrud4; Kjersti Flatmark5,6; Wolfgang Walther2; Beate Rau1;

Ulrike Stein2,3

1Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Campus Charité

Mitte und Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin,

Berlin, Deutschland

2Translationale Onkologie Solider Tumore, Experimental and Clinical Research

Center, Charité - Universitätsmedizin Berlin und Max-Delbrück Zentrum für

Molekulare Medizin in der Helmholz-Gemeinschaft, Berlin, Deutschland

3Deutsches Konsortium für Translationale Krebsforschung, Heidelberg,

Deutschland

4Department of Clinical and Molecular Medicine, Norwegian University of

Science and Technology, Trondheim, Norwegen

5Department of Tumor Biology, Institute for Cancer Research, Norwegian

Radium Hospital, Oslo University Hospital, Oslo, Norwegen

6Section for Surgical Oncology, Norwegian Radium Hospital, Department

ofGastroenterological Surgery, Oslo University Hospital, Oslo, Norwegen

Background: Metastasis-associated in colon cancer-1 (MACC1) is a val-

uable biomarker for a variety of solid tumors. However, there is no data

concerning its role in Pseudomyxoma peritonei (PMP), a rare malignancy

of the peritoneum characterized by mucinous ascites and implants in the

abdominal cavity.

Methods: MACC1 circulating RNA was quantied in 68 serum samples

from PMP patients using qRT-PCR. Aer stratifying the samples into

a low- and high-MACC1 group, the patients’ clinical parameters were

correlated with MACC1 levels. Additionally, the only two commercially

available PMP cell lines with low endogenous MACC1 levels have been

transduced to establish MACC1 overexpressing models; the inuence of

MACC1 on the cell phenotype and response to cytostatics has been inves-

tigated using proliferation-, migration-, and apoptosis assays.

Result: Patients with high plasma levels of MACC1-RNA displayed sig-

nicantly worse postoperative survival rates as compared to patients with

low MACC1 levels (48 months vs. not reached at 31 months, p=0.033); a

similar trend was observed in terms of overall survival (78 months vs. not

reached at 45 months, p=0.071). No correlation was observed between

MACC1 levels and tumor grade, disease burden and RAS mutation status.

In comparison to control cells, MACC1-transduced PMP cells showed

increased proliferation- and migration rates and decreased sensitivity to

cisplatin and mitomycin C.

Discussion: MACC1 is a candidate prognostic biomarker in PMP; further

evaluation as a diagnostic biomarker by comparison with a control group

is required. e MACC1-induced changes in cellular phenotype and ther-

apy response imply it’s important role in disease progression, highlighting

its role as a potential therapeutic target.

Conclusion: Incorporating circulating MACC1 transcripts into the exist-

ing clinical workup could improve the accuracy of prognosis prediction in

PMP patients. Further investigation of MACC1 in PMP may help identify

new molecular therapy targets for this disease.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts224

764

Synergism of Glutamine Metabolism and NFATc1 and its

potential for enhanced therapeutic ecacy in PDAC

Laura Melissa Huhnold1; Zurine Bonilla del Rio1; Sercan Mercan1;

Reutlinger Kristina1; Christine Gibhardt2; Angela Boshnakovska3;

Sabrina Sulzer1; Jacob Hamm1; Peter Rehling3; Ivan Bogeski2; Umair Latif1;

Volker Ellenrieder1

1University Medical Center Goettingen, Clinic of Gastroenterology,

gastrointestinal Oncology and Endocrinology, Goettingen, Deutschland

2University Medical Center Goettingen, Molecular Physiology, Institute of

Cardiovascular Physiology, Goettingen, Deutschland

3University Medical Center Goettingen, Department of Cellular Biochemistry,

Goettingen, Deutschland

Background: Pancreatic ductal adenocarcinoma (PDAC) is known to be

aggressive and chemoresistant. Evidence suggests that metabolic rewiring

promotes these features. However, the underlying mechanisms that sup-

port tumor progression in a nutrient-poor environment and its clinical

implications remain elusive. Our aim was to dene the role of the Nuclear

Factor of Activated T-Cells 1 (NFATc1) to the hallmarks of metabolic

reprogramming and survival mechanisms in PDAC.

Methods: We employed in vitro experiments using human and murine

PDAC cell lines, patient-derived-xenogras and organoids to determine

gene regulation, cellular stress responses, metabolism and chemoresis-

tance. Quantitative, functional and molecular characterization was per-

formed in concert to nutrient-depleted conditions, chemotherapeutics

and signaling inhibition of Glutaminase and NFATc1.

Result: NFATc1 highly correlates to the expression and activity of key

enzymes in glutamine catabolism, e.g. alpha-ketoglutarate dehydroge-

nase, leading to enhanced oxidative phosphorylation and glutathione

requirements. Moreover, the presence of glutamine eects the expres-

sion of NFATc1, whereas loss of NFATc1 facilitates adaptation to nutrient

deprivation. Finally, inhibition of NFATc1 or its mediated pathways show

increased vulnerability to chemotherapeutic agents.

Discussion: Our ongoing study suggests that NFATc1 controls remod-

eling of metabolism, resulting in the addiction to glutamine. Aside the

role of NFATc1 in cellular stress responses, its involvement in anaple-

rotic reactions might provide a potential therapeutic target for the

aggressive NFATc1high subtype of PDAC by disrupting its metabolic bal-

ance in addition to antineoplastic drugs. Further studies will investigate

these ndings in vivo.

Conclusion: We demonstrate that progression and resistance of PDAC

is linked to NFATc1 through stress responses and metabolic reprogram-

ming, which orchestrates a theoretical platform for tailored treatment

strategies.

Disclosure Statement: e authors declare no conict of interest.

770

The synergy between the agent GP-2250 and Gemcitabine as

a new maintenance therapy approach for pancreatic cancer

ina PDX mouse model

Britta Majchrzak-Stiller1; Marie Buchholz1; Ilka Peters1; Stephan Hahn2;

Johanna Strotmann1; Thomas Müller3; Waldemar Uhl1; Chris Braumann4;

Phillip Höhn1

1St. Josef Hospital Universitätsklinikum der Ruhr-Universität Bochum Klinik für

Allgemein- u. Viszeralchirurgie Arbeitsgemeinschaft Molekulare und Klinische

Forschung, Bochum, Deutschland

2Ruhr-Universität Bochum Zentrum für Klinische Forschung (ZKF) Labor

für Molekulare Gastroenterologische Onkologie (MGO) der Medizinischen

Universitätsklinik Knappschaftskrankenhaus, Bochum, Deutschland

3Geistlich Pharma AG, Wolhusen, Schweiz

4Department of General, Visceral and Vascular Surgery, Evangelische Kliniken

Gelsenkirchen, Akademisches Lehrkrankenhaus der Universität Duisburg-Essen,

Gelsenkirchen, Deutschland

Background: e substance GP-2250, a novel Oxathiazinane deriv-

ative previously showed antineoplastic activity in vitro and in vivo in

pancreatic cancer cells and in patient-derived mouse xenogras (PDX)1.

e substance is currently under Phase I clinical trial (clinicaltrials.gov:

NCT03854110) in pancreatic ductal adenocarcinoma (PDAC).

Methods: In this study, we now show a high synergistic capacity of

GP-2250 in combination with Gemcitabine in a pancreatic cellline -and

PDX-model setting.

Result: In vitro, a minor active dose of GP-2250 combined with an inac-

tive dose of Gemcitabine showed almost a doubled cytotoxicity compared

to GP-2250 monotherapy in dierent pancreatic cancer cells (established

and primary lines). ese results were conrmed in our rst line in vivo

study, where this drug combination was superior in reducing tumor vol-

ume compared to Gemcitabine alone in all eight PDX-models. Further,

a combination of GP-2250 and Gemcitabine was able to induce a par-

tial remission of tumor volume in four of eight, and a stable disease in

in three of eight PDX models. Gemcitabine monotherapy was associated

with progressive disease in all PDX except one. In a subsequent mainte-

nance setting following two weeks of treatment with nab-Paclitaxel plus

Gemcitabine, four PDX showed partial reduction and three showed a sta-

ble disease, whereas Gemcitabine in monotherapy resulted in progressive

disease in six of eight PDX models.

Discussion: e results proved this combination therapy to be highly

eective on both, established cells and primary cell lines, as well as in vivo

on PDX models of PDAC while retaining a low toxicity prole.

Conclusion: In view of its high tolerability, the use of the GP-2250/

Gemcitabine combination in maintenance therapy following nab-Pacli-

taxel/Gemcitabine as rst-line treatment appears as a highly promising

drug combination therapy.

1. Buchholz M. et.al. Innovative substance 2250 as a highly promising

anti-neoplastic agent in malignant pancreatic carcinoma - in vitro and in vivo.

BMC cancer 2017;17:216.

Disclosure Statement: e authors declare the following: Forschungskooperation.

776

Increasing the cytotoxic eectivity of 5FU, Irinotecan and

Oxaliplatin on pancreatic cancer cells through combination

with the novel anticancer agent GP-2250 in vitro

Ilka Peters1; Britta Majchrzak-Stiller1; Marie Buchholz1; Philipp Höhn1;

Thomas Müller2; Waldemar Uhl1; Chris Braumann3; Johanna Strotmann1

1Department of General and Visceral Surgery, St. Josef-Hospital, Ruhr-University

Bochum, Bochum, Deutschland

2Geistlich Pharma AG, Wolhusen, Schweiz

3Department of General, Visceral and Vascular Surgery, Evangelisches

Krankenhaus Herne, Akademisches Lehrkrankenhaus der Ruhr-Universität

Bochum, Herne, Deutschland

Background: e oxathiazinan derivative GP-2250 has a selective cyto-

toxic eect on various tumor entities in vitro and in vivo. As part of a

clinical Phase I trial, the substance is currently administered in combina-

tion with Gemcitabine aer FOLFIRNOX treatment. Especially in combi-

nation with Gemcitabine, GP-2250 showed a distinct synergy, enhancing

the eectivity of Gemcitabine and reducing the occurrence of secondary

resistances, without amplication of adverse events in vivo [1].

Methods: To evaluate, if GP-2250 might also enhance the eciency

of the FOLFIRINOX Regimen, the cytotoxicity of 5FU, Irinotecan

and Oxaliplatin in combination with GP-2250 was evaluated in vitro.

Pancreatic cancer cell lines were seeded for an MTT cytotoxicity assay

and treated with the single substances and their combinations. Aer incu-

bation time of 48 h, the cell viability was measured and the synergy was

evaluated according to the Chou-Talalay combination index.

Result: Combination of GP-2250 with all three chemotherapeutic sub-

stances did indeed increase their cytotoxic eect signicantly and dis-

played a promising synergism.

Discussion: is indicates that GP 2250 may also be a promising option

to improve the eectivity of the FOLFIRINOX regimen.

Conclusion: e results form a solid foundation for further in vivo stud-

ies to validate the synergy and to get a rst assessment of the toxicity.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 225

Reference:

1 Buchholz, M. and Strotmann, J et al.: New erapy Options for

Neuroendocrine Carcinoma of the Pancreas—e Emergent Substance

GP-2250 and Gemcitabine Prove to Be Highly Eective without the

Development of Secondary Resistances In Vitro and In Vivo. Cancers 2022, 14,

2685. https://doi.org/10.3390/cancers14112685.

Disclosure Statement: e authors declare the following: Forschungskooperation.

792

Human patient-derived organoid model as a promising tool

to study cytotoxic treatment eects on glioblastoma cells:

atechnical note

Meng-Chun Hsieh1; Ahmad Melhem1; Barbara E. F. Pregler1; Andreas Dolf2;

Andreas Waha3; Torsten Pietsch3; Hartmut Vatter1; Michael Hölzel4;

Ulrich Herrlinger5; Anna-Laura Pottho1; Matthias Schneider1

1Department of Neurosurgery, University Hospital Bonn, Bonn, Deutschland

2Flow Cytometry Core Facility, Medical Faculty, University of Bonn, Bonn,

Deutschland

3Department of Neuropathology, University Hospital Bonn, Bonn, Deutschland

4Institute of Experimental Oncology, University Hospital Bonn, Bonn,

Deutschland

5Division of Clinical Neuro-Oncology, Department of Neurology, University

Hospital Bonn, Bonn, Deutschland

Introduction: Tumor organoid models have emerged as a powerful tool

in cancer research. By avoiding clonal selection and preserving the tumor’s

local cytoarchitecture, three-dimensional organoids provide a more phys-

iologically relevant platform for studying the heterogeneity of cancer cells

and drug responses. However, valid methodological approaches for cell

death analyses applying ow cytometry are lacking. Using glioblastoma

organoids (GBOs) as an exemplary tumor model, we developed a protocol

to measure cell death as an important readout in cancer research.

Materials and Methods: Human GBOs were generated out of patient-

derived tumor material from neurosurgical resections. Temozolomide

(TMZ) and lomustine (CCNU) were used as cytotoxic agents commonly

employed in glioblastoma therapy. A protocol - originally published by

Nicoletti et al. for cell culture monolayers – was rened to assess cell death

in GBOs using ow cytometric analysis of propidium-iodide (PI)-stained

nuclei. Specic DNA fragmentation rates served as a surrogate readout

for cell death. Hoechst 33258 staining was utilized as a validation tool for

the adapted protocol.

Results: Aer treatment of 288 hours with physiologically-relevant

concentrations of TMZ and CCNU, DNA fragmentation rates in the

subG1-peak reached up to 65%. e results were consistent between both

biologic and technical replicates. Hoechst staining conrmed cell death

rates obtained from PI-based uorescence activated cell sorting analysis.

Discussion: Further improvements are needed to enable cell sorting for

immune and endothelial cells to perform readout analysis specically for

the tumor cell fraction in GBOs.

Conclusions: e rened Nicoletti protocol is a feasible and valid tool to

quantify cell death rates under dierent treatment conditions in organoids

using ow cytometry.

Disclosure Statement: e authors declare no conict of interest.

801

Categorization of Variants of Uncertain Signicance(VUS)

byDNA repair and replication assays

Benedikt Heitmeir; Miriam Deniz; Wolfgang Janni; Rebecca Jansche;

Lisa Wiesmüller

Universitätsfrauenklinik Ulm, Ulm, Deutschland

Background:. Today risk gene detection fully relies on the use of

NG-Sequencing, resulting in large numbers of variants of unknown

signicance (VUS). One core challenge therefore is to categorize newly

identied risk gene variants to accurately counsel the respective patients.

TP53 is a risk gene with high penetrance, underscoring the importance

of eorts to categorize TP53 VUS. While several assays based on canoni-

cal functions have been engaged a multitude of variants remained where

these assays oen produced inconclusive or contradictory data.

Methods: Our goal is to classify VUS of TP53 through DNA repair and

replication assays, by focusing on novel and underexplored non-canon-

ical functions of TP53. us, we are examining the prociency of VUS

to bypass replication barriers as compared to non-pathogenic and patho-

genic variants by (i) measuring the track length of nascent DNA synthesis

via DNA Fiber Assay, and (ii) quantication of recombination mediated

bypass of replication barriers via our established uorescence-based

reporter assay.

Result: We have been able to show a highly signicant dierence in DNA

ber track length between the dierent wild-type and pathogenic variants.

is is caused by a bypass of replication barriers via translesional DNA

replication which is faster than fork remodelling, yet mutagenic. ese

results are mirrored in our reporter-based assay where we were able to

show corresponding dierences in the frequency of the recombination

mediated-bypass in wild-type-like and pathogenic variants of TP53.

Discussion: We have been able to detect the impaired function in TP53

variants even when canonical assays fail. To further our goal of classify-

ing these VUS we are examining the complete spectrum of German TP53

variants. Our research has already led to the reclassication of one likely

pathogenic VUS providing access to intensive clinical care program.

Conclusion: We have been able to establish novel assays for improved

classication of previously enigmatic TP53 variants by exploiting so far

underexplored non-canonical functions of p53.

Disclosure Statement: e authors declare no conict of interest.

827

Mistletoe extracts inhibit colorectal cancer cell growth in vitro

Sebastian Wolfshöfer1; Martina Gast1; Friedemann Schad2;

Sebastian Stintzing1; Patricia Grabowski1,2

1Charité Campus Mitte - Charité Campus Mitte - Medizinische Klinik m.S.

Hämatologie, Onkologie und Tumorimmunologie, Berlin, Deutschland

2Gemeinschaftskrankenhaus Havelhöhe Klinik für Anthroposophische Medizin,

Berlin, Deutschland

Background: Colorectal cancer is the second most common cause of

cancer-related deaths worldwide and among the most frequently diag-

nosed cancers in Germany. Adjuvant chemotherapy is standard treatment

aer surgical removal of primary tumors, but development of resistance

is common. Administration of mistletoe (Viscum album) extracts can

improve quality of life for patients, by reducing side eects of treatment

with chemotherapeutic agents. ese extracts demonstrate immunomod-

ulatory properties, which have the potential to improve the eectivity of

anti- tumor therapy. Furthermore, in vitro experiments suggest a direct

eect on growth of colorectal cancer cells. However, the underlying

intra-cellular processes and modulated pathways have not been analyzed

suciently.

Methods: e eects of two mistletoe extracts, HelixorA® (host: r) and

Helixor M® (host: apple tree), on cell viability were assessed by MTT assay

in six dierent colorectal cancer cell lines. Cell cycle was analyzed by ow

cytometry. Multiplex gene expression analyses were conducted to assess

involved signaling pathways and key results were validated on protein

level by western blot analysis.

Result: Both mistletoe extracts were able to decrease cell viability in all

six investigated colorectal cancer cell lines. SW480 and Caco2 cells were

most susceptible to both extracts. e combination of mistletoe extract

to 5-FU therapy reduced cell viability by additional 50% in SW480 cells

and by 30% in Caco2 cells, indicating an additive eect. Gene expression

analysis highlighted the involvement of Myc signaling. e reduction of

c-Myc protein levels was conrmed in both cell lines.

Discussion: We demonstrated that mistletoe extracts can inhibit prolifer-

ation in colorectal cancer cells alone and in combination with 5-FU. Our

results implicate a role of c-Myc reduction in the antiproliferative eects

caused by mistletoe extracts.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts226

Conclusion: Further research in vitro and in vivo is needed to investigate the

potential of mistletoe extracts as direct therapeutic agents in colorectal cancer.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

862

DanioCTC: Analysis of circulating tumor cells from metastatic

breast cancer patients in zebrash xenografts

Florian Reinhardt1; Luisa Coen1; Mahdi Rivandi1; André Franken1;

Eunike Setyono2,3; Tobias Lindenberg4; Jens Eberhardt5; Tanja Fehm1;

Dieter Niederacher1; Franziska Knopf2,3; Hans Neubauer1

1Department of Obstetrics and Gynecology, Heinrich Heine University of

Duesseldorf, Duesseldorf, Deutschland

2Center for Regenerative Therapies TU Dresden (CRTD), Center for Molecular

and Cellular Bioengineering (CMCB), TU Dresden, Dresden, Deutschland

3Center for Healthy Aging, Faculty of Medicine Carl Gustav Carus, TU Dresden,

Dresden, Deutschland

4Anatomical Institute, Neuroanatomy, Medical Faculty, University of Bonn,

Bonn, Deutschland

5ALS Automated Lab Solutions GmbH, Jena, Deutschland

Circulating tumor cells (CTCs) serve as crucial metastatic precursor

cells, but their study in animal models has been hindered by their low

numbers. To address this challenge, we present DanioCTC, an innova-

tive xenogra workow that overcomes the scarcity of patient-derived

CTCs in animal models. By combining diagnostic leukapheresis (DLA),

the Parsortix microuidic system, ow cytometry, and the CellCelector

setup, DanioCTC eectively enriches and isolates CTCs from metasta-

sized breast cancer (MBC) patients for injection into zebrash embryos.

Validation experiments conrmed that MDA-MB-231 cells, transplanted

following the standard protocol, localized frequently to the head and

blood-forming regions of the zebrash host. Notably, when MDA-MB-231

cells spiked into DLA aliquots were processed using DanioCTC, cell dis-

semination patterns remained consistent. Successful xenograing of

CTCs from a MBC patient revealed their primary localization in the head

and trunk regions of zebrash embryos.

DanioCTC represents a major step forward in endeavors to study the dis-

semination of individual and rare patient-derived CTCs, thereby enhanc-

ing our understanding of metastatic breast cancer biology and facilitating

the development of targeted interventions in MBC.

Disclosure Statement: e authors declare no conict of interest.

904

The tight junction protein claudin 18.2 is markedly and

therapeutically relevant heterogeneously distributed

incarcinomas of the upper gastrointestinal tract

Alexander Quaas

Universitätsklinik Köln, Institut für Pathologie, Köln, Deutschland

Background: Claudin 18.2 protein is overexpressed in adenocarcinoma of

the upper GI-tract. Zolbetuximab is a therapeutic monoclonal antibody

against Claudin 18.2 for therapy of HER2/neu-negativeupper GI-tract

carcinomas. Immunohistochemical staining was established as a predictive

biomarker. Little is known about its expression in the real-world patient

populations and its heterogeneity within the tumor and their metastases.

Methods: Paran-embedded tumor material from 1,283 patients (822

esophageal adenocarcinomas (EAC) and 461 gastric adenocarcinomas

(GAC) was analyzed for claudin 18.2 expression status. e immunohis-

tochemical antibody clone 43-11A used in the Spotlight study was applied.

Single and multi-spot tissue microarrays (TMAs) and whole tumor blocks

from primary tumors and lymph node metastases were analyzed. Eight

virtual endoscopic biopsies were taken from digitized whole tumor blocks.

Result: 24.8% of EAC and 28,6% of GAC were positive for CLDN18.2.

When comparing the results of only one single core biopsy with the

whole tissue section, the sensitivity for CLDN18.2 was low (58.8%).

e sensitivity increased to a maximum of 76.5% with 6 and 8 biopsies.

Discordant expression between primary tumor and corresponding local

lymph node metastasis was observed in 18.5%.

Discussion: e extent of claudin 18.2 positive carcinomas is lower than

in the Spotlight study (38%). In almost every h case, dierent expres-

sion results between the primary tumor and lymph node metastases can be

expected. At least six endoscopically obtained biopsies is necessary to obtain

a realistic picture of the actual expression status of the tumor for claudin

18.2. Comparable results have also been published for Her2/neu and PD-L1.

Conclusion: Claudin 18.2 is a heterogeneously expressed biomarker. In

the case of negative claudin 18.2 results, it must be clear on what evidence

this result is based. If necessary, a re-biopsy of the tumor or a biopsy of

metastases should be considered.

Disclosure Statement: e authors declare the following: Consulting contract with

Astellas-Pharma.

917

The Clonal Relationship and the Clinical Value of EpCAM

High-Expressing and Low-Expressing Circulating Tumor Cells

in Metastatic Breast Cancer

André Franken1; Annika Krämer1; Alicia Sicking1; Meike Watolla1,

Mahdi Rivandi1; Liwen Yang1; Jens Warfsmann2; Bernhard Polzer2;

Thomas W. P. Friedl3; Franziska Meier-Stiegen1; Nikolas H. Stoecklein4;

Wolfgang Janni3; Sabine Riethdorf5; Klaus Pantel5; André Koch6,

Natalia Krawczyk1; Dieter Niederacher1; Tanja Fehm1; Hans Neubauer1

1Department of Obstetrics and Gynecology, University Hospital and Medical

Faculty of the Heinrich-Heine University Duesseldorf, Düsseldorf, Deutschland

2Division “Personalized Tumor Therapy”, Fraunhofer Institute for Toxicology and

Experimental Medicine, Regensburg, Deutschland

3Department of Gynecology and Obstetrics, University Hospital Ulm, Ulm,

Deutschland

4General, Visceral and Pediatric Surgery, University Hospital and Medical Faculty

of the Heinrich Heine University Duesseldorf, Düsseldorf, Deutschland

5Department of Tumor Biology, University Hospital Hamburg-Eppendorf,

Hamburg, Deutschland

6Department of Obstetrics and Gynecology, University of Tübingen, Tübingen,

Deutschland

Background: Circulating tumor cells (CTCs) are mainly enriched based

on the epithelial cell adhesion molecule (EpCAM). Although it was shown

that an EpCAM low-expressing CTC fraction is not captured by such

approaches, knowledge about its prognostic and predictive relevance and its

relation to the EpCAM positive CTC subpopulation is lacking. To close this

gap of knowledge we developed an immunomagnetic assay to enrich CTCs

EpCAM-independently enabling the comparison of EpCAM high express-

ing and EpCAM low expressing CTCs obtained from the same patient.

Methods: CTCs were enriched from blood samples of metastatic breast

cancer patients using antibodies targeting Trop-2 and CD-49f. eir

EpCAM expression was determined by uorescence microscopy and

EpCAM high expressing and low expressing CTCs were isolated as single

cells. eir genomic DNA was amplied and analyzed regarding chromo-

somal aberrations and predictive mutations. Additionally, we compared

enrichment of CTCs using this antibody mix with the EpCAM based

enrichment using the CellSearch system.

Result: e combined application of antibodies against Trop-2 and

CD-49f achieved a synergistic eect on the CTC yield. Patients with

EpCAM high-expressing CTCs had a worse overall and progression free

survival. EpCAM high- and low-expressing CTCs presented similar chro-

mosomal aberrations and mutations indicating a close evolutionary rela-

tionship. A sequential enrichment of CTCs from the EpCAM depleted

fraction yielded a population of CTCs not captured EpCAM dependently

but harboring predictive information.

Conclusion: Our data indicate that EpCAM low-expressing CTCs could be

used as a valuable tumor surrogate material – although they may be prognos-

tically less relevant than EpCAM high-expressing CTCs – and have partic-

ular benet if no CTCs are detected using EpCAM dependent technologies.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 227

Late-Breaking Abstracts

Best-of-Abstract-Vortrag

Breast Cancer

1075

Inavolisib or placebo in combination with palbociclib and

fulvestrant in patients with PIK3CA-mutated, hormone

receptor-positive, HER2-negative locally advanced or

metastatic breast cancer: Phase III INAVO120 primary analysis

Sherko Kümmel1; Komal Jhaveri2; Seock-Ah Im3; Cristina Saura4;

DejanJuric5; Sibylle Loibl6; Kevin Kalinsky7; Peter Schmid8; Sherene Loi9;

Eirini Thanopoulou10; Noopur Shakar11; Guiyuan Lei10; Thomas Stout11;

Katherine Hutchinson11; Jennifer Schutzman11; Chunyan Song11;

NicholasTurner12

1Kliniken Essen-Mitte, Evangelische Huyssens-Stiftung/Knappschaft GmbH

Essen, Deutschland

2Breast and Early Drug Development Service, Department of Medicine,

Memorial Sloan Kettering Cancer Center, New York, NY, and Weill Cornell

Medical College, New York, USA

3Seoul National University Hospital, Seoul National University College of

Medicine, Cancer Research Institute, Seoul National University, Seoul, Republic

of Korea

4Breast Cancer Unit, Medical Oncology Service, Vall d’Hebron University

Hospital, Barcelona, Spain

5Medicine-Hematology and Medical Oncology, Massachusetts General Hospital

Cancer Center, Boston, USA

6German Breast Group, Neu-Isenburg, Germany; Centre for Haematology and

Oncology Bethanien, Goethe University, Frankfurt, Germany

7Winship Cancer Institute at Emory University, Atlanta, USA

8Centre for Experimental Cancer Medicine, Barts Cancer Institute, Queen Mary

University of London, London, United Kingdom

9Division of Cancer Research, Peter MacCallum Cancer Centre, Melbourne,

Australia, and The Sir Peter MacCallum Department of Medical Oncology,

University of Melbourne, Parkville, Australien

10Roche Products Limited. Welwyn Garden City, United Kingdom

11Genentech, Inc., South San Francisco, USA

12Centre for Molecular Oncology, Royal Marsden Hospital and Institute of Cancer

Research, London, United Kingdom

Background: More eective treatments for patients (pts) with endocrine-

resistant, PIK3CA-mutated, hormone receptor-positive, HER2-negative

breast cancer (HR+, HER2– BC) that prevent or overcome resistance are

needed. Inavolisib is a highly potent and selective inhibitor of the PI3K

catalytic subunit α isoform protein. Prior preclinical data suggested sub-

stantial synergy between PI3K and cyclin-dependent kinase 4/6 inhibition

plus endocrine therapy.

Methods: e Phase III, randomized, double-blind INAVO120 trial

(NCT03006172) recruited 325 pts with PIK3CA-mutated, HR+, HER2–

locally advanced/metastatic BC (LA/mBC) who relapsed during or within

12 months of adjuvant endocrine therapy completion, and who had no

prior therapy for advanced BC. Pts were randomized to inavolisib (inavo)

(9 mg qd on Days 1–28 of each cycle) or placebo (qd) in combination

with palbociclib (palbo) (125 mg qd on Days 1–21 of each cycle) and ful-

vestrant (fulv) (500 mg im on Cycle 1 Days 1 and 15, and on Day 1 of

each subsequent cycle). e primary endpoint was investigator-assessed

progression-free survival (INV-PFS).

Result: Aer 21.3 months median follow-up, median INV-PFS was

15.0months (95% CI = 11.3, 20.5) with inavo+palbo+fulv, and 7.3 months

(95% CI = 5.6, 9.3) with placebo+palbo+fulv (hazard ratio 0.43; 95% CI =

0.32, 0.59). OS showed a trend in favor of inavo (hazard ratio 0.64; 95%

CI = 0.43, 0.97; p = 0.0338), with follow-up ongoing. Rates of selected

Grade 3–4 AEs with inavo and placebo were: neutropenia at 80.2% and

78.4%; hyperglycemia at 5.6% and 0%; diarrhea at 3.7% and 0%; stomatitis

and mucosal inammation at 5.6% and 0%; and rash at 0% and 0%.

Discussion: Inavo + palbo + fulv demonstrated a statistically signicant

and clinically meaningful improvement in INV-PFS in this high-risk

population, and a favorable OS trend at the rst interim analysis. Inavo

+ palbo + fulv had a manageable safety prole and no new safety signal

was identied.

Conclusion: Inavo + palbo + fulv could represent a new standard of care

for pts with PIK3CA-mutated, HR+, HER2– LA/mBC.

Prev. presented at SABCS, Jhaveri et al

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

1085

Adjuvant abemaciclib plus endocrine therapy for HR+, HER2-,

high-risk early breast cancer: results from a preplanned

monarchE overall survival interim analysis, including 5-year

ecacy outcomes

Mattea Reinisch1; Nadia Harbeck2; Priya Rastogi3; Joyce O’shaughnessy4;

Frances Boyle5; Javier Cortes6, 7; Hope S. Rugo8; Erika Hamilton9; MatthewP.

Goetz10; Chiun-Sheng Huang11; Elżbieta Senkus12; AlexeyTrakin13; Patrick

Neven14; Jens Huober15; Wei Ran16; Valerie Andre16; Maria Munoz-

Fernandez16; Belen San Antonio16; Ashwin Shahir16; MiguelMartín17;

Stephen Johnston18

1Evang. Kliniken Essen-Mitte, Clinic for Gynecology / Breast Center, Essen,

Deutschland

2Breast Centre, Department of Gynecology and Obstetrics, Comprehensive

Cancer Centre München, LMU University Hospital, München, Deutschland

3UPMC Hillman Cancer Center and NSABP Foundation, Pittsburgh, PA, USA

4Baylor University Medical Center, Texas Oncology, US Oncology, Dallas, TX, USA

54Sydney Medical School, University of Sydney, Sydney, NSW, Australien

65International Breast Cancer Center (IBCC), Quironsalud Group, Barcelona

7International Breast Cancer Center (IBCC), Quironsalud Group, Barcelona,

Spanien

8Department of Medicine, University of California San Francisco, Helen Diller

Family Comprehensive Cancer Center, San Francisco, CA, USA

9Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN, USA

10Mayo Clinic, Rochester, MN, USA

11Department of Surgery, National Taiwan University Hospital, National Taiwan

University College of Medicine, Taipei City, Taiwan

12Medical University of Gdańsk, Gdańsk, Polen

13N.N. Blokhin Russian Cancer Research Center, Moscow, Russische Föderation

14Multidisciplinary Breast Center, University Hospitals Leuven, Louvain, Belgien

15Breast Center, Kantonsspital St. Gallen, St. Gallen, Schweiz

16Eli Lilly and Company, Indianapolis, IN, USA

17Hospital General Universitario Gregorio Marañon, Universidad Complutense,

CIBERONC, GEICAM, Madrid, Spanien

18The Royal Marsden NHS Foundation Trust, London, United Kingdom

Background: Two years (yrs) of adjuvant abemaciclib combined with

endocrine therapy (ET) resulted in signicant improvement in invasive dis-

ease-free survival (IDFS) and distant relapse-free survival (DRFS) that per-

sisted beyond the 2-yr treatment (tx) period in patients (pts) with hormone

receptor positive, human epidermal growth factor receptor 2 negative,

node-positive, high-risk early breast cancer (EBC). Here, we report 5-yr

ecacy results from a prespecied overall survival (OS) interim analysis.

Methods: Pts were randomized (1:1) to receive ET for at least 5 yrs +/-

abemaciclib for 2 yrs (tx period). High-risk EBC was dened as either ≥4

positive axillary lymph nodes (ALN) or 1-3 ALN with Grade 3 disease

and/or tumor ≥5 cm (Cohort 1). A smaller group of pts were enrolled with

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts228

1-3+ ALN and central Ki67 ≥20% (Cohort 2). e intent-to-treat (ITT)

population consisted of Cohort 1 (5120 pts) and Cohort 2 (517 pts).

Results: In the ITT population, with a median follow-up of 54 months,

the benet of abemaciclib was sustained with a HR of 0.680 (95% CI:

0.599, 0.772) for IDFS and 0.675 (95% CI: 0.588, 0.774) for DRFS. is

persistence of abemaciclib benet translated to continued separation of

the KM curves resulting in a 5-yr absolute improvement in IDFS and

DRFS rates of 7.6% and 6.7%, respectively, compared with IDFS/DRFS

rates of 6.0%/5.3% at 4 yrs and 4.8%/4.1% at 3 yrs. Tx benet in Cohort 1

was consistent with ITT. No new safety signals were observed. ere con-

tinued to be fewer deaths in the abemaciclib plus ET arm compared to the

ET arm (208 vs 234; HR 0.903; p=0.284); signicance was not met.

Discussion: At the pivotal 5-yr mark for adjuvant EBC trials, abemaciclib

plus ET continued to reduce the risk of developing invasive and distant

disease recurrence well beyond the completion of tx.

Conclusions: e increasing absolute improvement at 5 yrs is consistent

with a carryover eect and further supports the use of abemaciclib in pts

with high-risk EBC. OS data are evolving in favor of abemaciclib arm, and

follow-up continues.

Disclosure Statement: e authors declare the following: Vortrags- oder

Beratungshonorare oder Reisekostenübernahmen erhalten: AstraZeneca, Daiichi

Sankyo, Gilead, Lilly, MSD, Novartis, Pzer, Roche, Seagen and Somatex.

Endocrine Tumors

1133

Randomized phase 3 study of selpercatinib versus

cabozantinib or vandetanib in advanced, kinase inhibitor-

naïve, ret-mutant medullary thyroid cancer

Julien Hadoux1; Rosella Elisei2; Marcia Brose3; Ana Ho4; Bruce Robinson5;

Ming Gao6; Barbara Jarzab7; Pavel Isaev8; Katerina Kopeckova9;

JonathanWadsley10; Dagmar Führer11; Bhumsuk Keam12; Eric Sherman13;

Makoto Tahara14; Mimi Hu15; Yan Lin16; Patricia Maeda16; Lori Wirth17;

Jaume Capdevila18

1Gustave Roussy, Villejuif, Frankreich

2Endocrine Unit, Department of Clinical and Experimental Medicine, University

of Pisa, Pisa, Italien

3Sidney Kimmel Medical College, Philadelphia, USA

4Instituto do Câncer do Estado de São Paulo, Sao Paulo, Brasilien

5School of Medicine, Western Sydney University, Campbelltown, Australien

6Tianjin Cancer Institute & Hospital, Tianjin, China, VR

7Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska

Curie National Research Institute of Oncology, Gliwice Branch, Polen

8Federal State Institution Medical Radiology Research Center, Obninsk,

Russische Föderation

9Department of Oncology, 2nd Faculty of Medicine of Charles University and

Motol University Hospital, Prague, Tschechische Republik

10Clinical Oncology Department, Weston Park Cancer Center, NHS Foundation

Trust, Sheied, United Kingdom

11Department of Endocrinology Diabetology and Metabolism, Endocrine

Tumour Center at West German Cancer Center, University Hospital Essen,

University of Duisburg-Essen, Essen, Deutschland

12Seoul National University Hospital, Seoul, Republik Korea

13Department of Medical Oncology, Memorial Sloan Kettering Cancer Center,

New York, USA

14National Cancer Center Hospital East, Kashiwa, Japan

15University of Texas MD Anderson Cancer Center, Houston, USA

16Eli Lilly and Company Corporate Center, Indianapolis, USA

17Massachusetts General Hospital, Boston, USA

18Medical Oncology Department, Vall d’Hebron Institute of Oncology,

Universitat Autònoma de Barcelona, Barcelona, Spanien

Background: Selpercatinib is a highly selective and potent RET inhibitor

approved for advanced RET-mutant medullary thyroid carcinoma (MTC)

but has not been directly compared with approved multikinase inhibitors

(MKI).

Methods: LIBRETTO-531 (NCT04211337) is a randomized phase 3 study

comparing rst-line selpercatinib versus cabozantinib or vandetanib.

Eligible patients had kinase inhibitor-naïve progressive disease documented

in the 14 months prior to enrollment. e pre-planned interim ecacy anal-

ysis occurred aer 59 progression-free survival (PFS) events. e primary

endpoint was blinded independent central review (BICR)-assessed PFS.

Result: In total, 291 patients were randomized. At a median follow-up

of 12 months, median PFS by BICR was not reached with selpercatinib

remaining inestimable (95% CI: NE, NE) and was 16.8 months (95%

CI: 12.2, 25.1) with control (HR: 0.280, 95% CI: 0.165, 0.475; P<.0001); by

investigator assessment the HR was 0.187 (95% CI: 0.109, 0.321; P<.0001).

BICR overall response rate (ORR) was 69.4% (95% CI: 62.4, 75.8) with

selpercatinib compared to 38.8% (95% CI: 29.1, 49.2) with control (odds

ratio 3.7, 95% CI, 2.2, 6.3; P<0.0001). At a median follow-up of 15 months,

overall survival (OS) was better with selpercatinib (HR: 0.374, 95% CI:

0.147, 0.949). e most common treatment-emergent adverse events

observed with selpercatinib were hypertension, dry mouth, and diarrhea;

and with control, diarrhea, palmar-plantar erythrodysaesthesia syndrome,

and hypertension. In total, 38.9% of patients treated with selpercatinib

had a dose reduction (versus 77.3% in control) and 4.7% discontinued

treatment due to an adverse event (versus 26.8% in control).

Discussion: e study met the interim analysis criteria of ecacy. First-

line selpercatinib delivered markedly prolonged PFS, improved ORR, and

better OS compared with MKI.

Conclusion: is study highlights the importance of selectivity in target-

ing RET-mutant MTC. Selpercatinib should be considered the preferred

rst-line standard of care for patients with advanced RET-mutant MTC.

Disclosure Statement: e authors declare the following: Mitgliedscha in

Beratungsgremien, Forschungsunterstützungen, Drittmittel

Gastrointestinal Cancer: other than colorectal

1141

Treatment response prediction and tumor evolution captured

in patient-derived organoids – Towards true precision

medicine in pancreatic cancer

Thomas Seuerlein1; Johann Gout2; Yazid J. Resheq1; Jessica

Lindenmayer3; Julian Schwab4; Johann Kraus4; Elodie Roger2;

DhariniSrinivasan2; Julia Kühlwein5, 6; Mark Hänle1; Thomas J. Ettrich1;

Karin Danzer5, 6; Alica K. Beutel7; Lukas Perkhofer2, 8; Hans Armin Kestler4;

Alexander Kleger2, 3, 8

1Department of Internal Medicine I, Ulm University Hospital, Ulm, Deutschland

2Institute for Molecular Oncology and Stem Cell Biology, Ulm University

Hospital, Ulm, Deutschland

3Core Facility Organoids, Ulm University, Ulm, Deutschland

4Institute of Medical Systems Biology, Ulm University, Ulm, Deutschland

5German Center for Neurodegenerative Diseases (DZNE), Ulm University, Ulm,

Deutschland

6Department of Neurology, Ulm University Hospital, Ulm, Deutschland

7University of California Irvine, Irvine, USA

8Division of Interdisciplinary Pancreatology, Department of Internal Medicine I,

Ulm University Hospital, Ulm, Deutschland

Background: Pancreatic cancer (PC) is characterized by an aggressive

biology and high tumor heterogeneity causing considerable variations

in therapy response. Patient-derived organoids (PDOs) reect parental

tumor features and represent a powerful preclinical tool to predict drug

response and harness personalized treatment.

Methods: We have derived >100 PDO lines from treatment-naïve and

pretreated PC primary tumor and metastases with a reliable ecacy and

previously developed a pharmacotyping-guided prediction model to

prognosticate patient therapy response. Following up our initial feasibil-

ity trial, we validated the model accuracy in 43 PC patients. To decipher

molecular mechanisms driving PC chemoresistance, we conducted whole

exome sequencing (WES) on seven longitudinal patients and single-nu-

cleus RNA/ATAC multiomics on a unique longitudinal case study.

Results/Discussion: Automation and drug screening miniaturization

enhanced our process capacity, allowing to extend our drug panel and

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 229

reducing time before pharmacotyping. Our model allowed a successful

drug response prediction in naïve patients with an accuracy of 82.3%

for 1st and 2nd line regimens. Prediction power was lower in pretreated

patients with a precision of 58.3%. Analysis of longitudinal samples

revealed a CHEK2-mutated patient responding over time upon PARP

inhibitor maintenance therapy, in line with our prediction, further high-

lighting the method robustness. WES revealed lower mutational bur-

den, while tracking clonal evolution unmasked therapy-linked changes.

Integrative analysis identied transcriptomic and epigenetic dynamics in

a longitudinal patient with a FGFR2 fusion. FGFR2 constitutive activation

correlated with aberrant epigenetic trace and transcription programs of

downstream targets as PI3K-AKT, MAPK, and RAS family members and

of RNA polymerase II transcription machinery.

Conclusions: Overall, we report a robust and clinically-relevant pre-

clinical tool for drug response prediction, paving the way towards a

PDO-based true precision medicine in clinical routine.

Disclosure Statement: e authors declare no conict of interest.

1000

Pathological complete response (pCR) to durvalumab

plus 5-uorouracil, leucovorin, oxaliplatin and docetaxel

(FLOT) in resectable gastric and gastroesophageal junction

cancer (GC/GEJC): Interim results of the global, phase III

MATTERHORN study

Markus Möhler1; Yelena Janjigian2; Salah-Eddin Al-Batran3;

ZevWainberg4; Eric Van Cutsem5; Daniela Molena6; Kei Muro7;

WooJinHyung8; Lucjan Wyrwicz9; Do-Youn Oh10; Takeshi Omori11;

Marcelo Garrido12; Oliveira Sulene Cunha Sousa13; Moishe Liberman14;

Victor Castro Oliden15; Mehmet Bilici16; John F. Kurland17; Ioannis Xynos18;

Helen Mann18; Josep Tabernero19

1Research Center for Immunotherapy (FZI), Johannes Gutenberg-University

Clinic, Mainz, Deutschland

2Gastrointestinal Oncology Service, Memorial Sloan Kettering Cancer Center,

New York, USA

3Institute of Clinical Cancer Research, Krankenhaus Nordwest, University Cancer

Center, Frankfurt, Deutschland

4Department of Gastrointestinal Medical Oncology, David Geen School of

Medicine at UCLA, Los Angeles, USA

5Department of Gastroenterology / Digestive Oncology, University Hospitals

Leuven and KU Leuven, Leuven, Belgien

6Division of Thoracic Surgery, Memorial Sloan Kettering Cancer Center, New

York, USA

7Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan

8Department of Surgery, Yonsei University College of Medicine, Seoul, Republik

Korea

9Department of Oncology and Radiotherapy, Maria Sklodowska-Curie National

Research Institute of Oncology, Warsaw, Polen

10Division of Medical Oncology, Department of Internal Medicine, Seoul

National University Hospital; Cancer Research Institute, Seoul National

University College of Medicine, Seoul, Republik Korea

11Department of Gastroenterological Surgery, Osaka International Cancer

Institute, Osaka, Japan

12Hemato-Oncology Department, SAGA Clinical Trial Centre and Universidad

Mayor, Santiago, Chile

13Clinical Oncology, The Clinical Research Center, Northern Riograndense

League Against Cancer, Natal, Brasilien

14Division of Thoracic Surgery, Department of Surgery, Centre Hospitalier de

l’Université de Montréal, Centre de Recherche du CHUM, Montreal, Kanada

15Medicina Oncologica Department, National Institute of Neoplastic Diseases

(INEN), Lima, Peru

16Department of Medical Oncology, Atatürk University Faculty of Medicine,

Erzurum, Türkei

17Oncology R&D, Late-Stage Development, AstraZeneca, Gaithersburg, USA

18Oncology R&D, Late-Stage Development, AstraZeneca, Cambridge, United

Kingdom

19Medical Oncology Department, Vall d’Hebron Hospital Campus & Institute of

Oncology (VHIO), IOB-Quiron, UVic-UCC, Barcelona, Spanien

Background: e global, Phase 3, randomized, double-blind, pla-

cebo (P)-controlled MATTERHORN study (NCT04592913) assesses

perioperative durvalumab (D) with FLOT in participants (pts) with

resectable GC/GEJC. Results of a pre-planned interim analysis (IA) are

reported.

Methods: Pts with resectable (>T2 N0-3 M0/T0-4 N1-3 M0) GC/GEJC

were randomized 1:1 to D 1500 mg or P every 4 weeks (Q4W) on Day 1

plus FLOT Q2W on Days 1 and 15 for 4 cycles (2 doses of D or P and 4

doses of FLOT pre- and post-operative), followed by D 1500 mg or P on

Day 1 Q4W for 10 further cycles. IA was conducted aer all random-

ized pts underwent or were precluded from surgery. Superiority of pCR

rate (α=0.1% [2-sided]) by central review (Modied Ryan) was assessed.

Surgical and safety outcomes were also assessed.

Result: ere were 474 pts randomized to each treatment arm. Baseline

characteristics were balanced between arms; 19% of pts in each enrolled

in Asia. e majority of pts had GC (68%), cT3 (66%; cT4, 25%) and

cLN+ (70%). A statistically signicant improvement in pCR was observed

with addition of D to FLOT versus P (19% vs 7%; 12%; odds ratio [OR],

3.08; p<0.00001). Combined pCR/near-complete pathological response

(pnCR) rate was 27% with D vs 14% with P (13%; OR, 2.19; p<0.00001).

Surgery rate and R0 resection rate (in pts who underwent surgery) were

similar with D (87% and 86%, respectively) vs P (84% and 86%, respec-

tively). Downstaging favored D vs P (T0, 23% vs 11%; pN0, 52% vs 37%;

by central review) in pts who underwent surgery. Median D and P expo-

sure was similar. Adverse event rates were similar between arms.

Conclusion: e addition of D to perioperative FLOT therapy demon-

strated a clinically meaningful and statistically signicant improve-

ment in pCR in resectable GC/GEJC, with a tolerable safety prole. e

MATTERHORN study is ongoing for the primary endpoint of event-free

survival.

Indication of source: Previously presented at ESMO 2023, LBA73: same title as

above, Yelena.Y. Janjigian et al. - Reused with permission.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts230

Genitourinary Cancer including Prostate

Cancer

1057

Nivolumab (NIVO) + gemcitabine-cisplatin (GC) vs GC alone

for previously untreated unresectable or metastatic urothelial

carcinoma (mUC): results from the phase 3 CheckMate 901 trial

Jens Bedke1; Michiel S. van der Heijden2; Guru Sonpavde3;

ThomasPowles4; Andrea Necchi5; Mauricio Burotto6; Michael Schenker7;

Juan Pablo Sade8; Aristotelis Bamias9; Philippe Beuzeboc10;

JanOldenburg11; Yüksel Ürün12; Dingwei Ye13; Zhisong He14;

BegoñaP.Valderrama15; Yoshihiko Tomita16; Jeiry Filian17;

DanielaPurcea18; Federico Nasroulah17; Matthew Galsky19

1Department of Urology, Eberhard Karls University Tübingen, Tübingen,

Deutschland

2Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam,

Niederlande

3Medical Oncology, Genitourinary Section, Dana-Farber Cancer Institute,

Harvard Medical School, Boston, USA

4Department of Genitourinary Oncology, Barts Cancer Institute, Queen Mary

University of London, London, United Kingdom

5Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei

Tumori, Milan, Italien

6Department of Oncology, Bradford Hill Clinical Research Center, Santiago, Chile

7Department of Medical Oncology, Sf. Nectarie Oncology Center; Department

of Oncology, University of Medicine and Pharmacy, Craiova, Rumänien

8Department of Clinical Oncology, Alexander Fleming Institute, Buenos Aires,

Argentinien

9Second Propaedeutic Department of Medicine, National and Kapodistrian

University of Athens, ATTIKON University Hospital, Athens, Griechenland

10Department of Urologic Oncology, Hopital Foch, Suresnes, Frankreich

11Department of Oncology, Akershus University Hospital (Ahus), Lørenskog,

Norwegen

12Department of Medical Oncology, Ankara University, Ankara, Türkei

13Department of Oncology, Fudan University Shanghai Cancer Center, Shanghai,

China, VR

14Department of Urology, Peking University First Hospital, Beijing, China, VR

15Department of Medical Oncology, Hospital Universitario Virgen del Rocío,

Sevilla, Spanien

16Department of Urology, Niigata University Graduate School of Medical and

Dental Sciences, Niigata, Japan

17Bristol Myers Squibb, Princeton, USA

18Bristol Myers Squibb, Boudry, Schweiz

19Department of Medicine, Tisch Cancer Institute, Icahn School of Medicine at

Mount Sinai, New York, USA

Background: Cisplatin (cis)-based chemotherapy (chemo) has been the

rst-line standard of care (SOC) for cis-eligible patients (pts) with mUC

for decades, and prior attempts to improve upon this treatment have been

unsuccessful. We report results for NIVO+GC or GC alone in CheckMate

901.

Methods: In CheckMate 901 (NCT03036098), a global, open-label, ran-

domized phase 3 trial, pts received NIVO 360 mg + GC Q3W for up

to 6 cycles followed by NIVO 480 mg Q4W until disease progression/

unacceptable toxicity or up to a maximum of 2 years, or GC Q3W for

up to 6 cycles. Stratication factors were PD-L1 status and liver metas-

tasis. Primary endpoints were overall survival (OS) and progression-free

survival (PFS) by blinded independent central review (BICR). Objective

response rate (ORR) per BICR was an exploratory endpoint.

Result: 304 pts were randomized to each arm. With a median follow-up

of 33.6 mo, both OS (HR, 0.78; 95% CI, 0.63–0.96; P = 0.0171) and PFS

(HR, 0.72; 95% CI, 0.59–0.88; P = 0.0012) were signicantly improved

with NIVO+GC vs GC. Median OS (95% CI) was 21.7 (18.6–26.4) vs 18.9

(14.7–22.4) mo for NIVO+GC vs GC, with OS probabilities of 70.2% vs

62.7% at 12 mo and 46.9% vs 40.7% at 24 mo; median PFS (95% CI) was

7.9 (7.6–9.5) vs 7.6 (6.1–7.8) mo, with PFS probabilities of 34.2% vs 21.8%

at 12 mo and 23.5% vs 9.6% at 24 mo. ORR and complete response (CR)

rates were 57.6% and 21.7% with NIVO+GC vs 43.1% and 11.8% with GC.

Median duration of CR (95% CI) was 37.1 (18.1–not estimable) mo for

NIVO+GC vs 13.2 (7.3–18.4) mo with GC. Grade ≥ 3 treatment-related

AEs occurred in 61.8% of pts in the NIVO+GC arm and 51.7% of pts in

the GC arm.

Discussion: NIVO+GC demonstrated statistically signicant and clin-

ically meaningful improvements in OS and PFS vs GC alone as rst-

line treatment for mUC with no new toxicity signals. NIVO+GC is the

rst frontline concurrent checkpoint inhibitor + chemo combination to

improve OS in this setting.

Conclusion: ese results support NIVO + cis-based chemo as a new

SOC for pts with mUC.

Previously presented at the ESMO Annual Meeting 2023, LBA7, van der Heijden

MS, et al. Reused with permission.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

Hematooncology including Bone marrow

transplantation, Lymphoma, Plasmocytoma

1054

Estimating the impact of radiotherapy in young,

high-risk patients with aggressive b-cell lymphoma:

along-term analysis of the open-label, randomized,

phase 3 R-MegaCHOEP trial

Michael Oertel1; Marita Ziepert2; Fabian Frontzek3; Nina Nacke1; Maike

Nickelsen4; Bertram Glaß5; Viola Poeschel6; Christian Rübe7; Georg Lenz3;

Norbert Schmitz3; Hans Theodor Eich1

1Klinik für Strahlentherapie - Radioonkologie - Universitätsklinikum Münster,

Münster, Deutschland

2Institut für Medizinische Informatik, Statistik und Epidemiologie - Universität

Leipzig, Leipzig, Deutschland

3Medizinischen Klinik A: Hämatologie, Hämostaseologie, Onkologie und

Pneumologie - Universitätsklinikum Münster, Münster, Deutschland

4Onkologie Lerchenfeld, Hamburg, Deutschland

5Hämatologie und Zelltherapie - Helios Klinikum Berlin-Buch, Berlin,

Deutschland

6Klinik für Innere Medizin I - Onkologie, Hämatol. Immun. & Rheumatololgie -

Universitätsklinikum des Saarlandes, Homburg, Deutschland

7Klinik für Strahlentherapie und Radioonkologie - Universitätsklinikum des

Saarlandes, Homburg, Deutschland

Background: e role of consolidative radiotherapy (RT) for patients

with aggressive B-cell lymphoma is to be dened. e R-MegaCHOEP

trial analyzed the use of high-dose chemotherapy and rituximab followed

by autologous stem cell transplantation compared to R-CHOEP immu-

nochemotherapy for patients up to 60 years1,2. e presented work ana-

lyzes the impact of RT regarding long-term ecacy and side-eects.

Methods: e analysis included 261 patients with a median follow-up of

112.4 months. Consolidative RT was indicated for extranodal involve-

ment or bulky disease (maximum diameter ≥ 7.5 cm). In addition, RT

could be administered because of insucient response at end of therapy.

Result: Overall, 120 patients underwent RT. Patients with RT had pre-

dominantly an age-adjusted IPI of 2 (75 %) and an elevated LDH (96.7

%). Bulky disease was present in 103/120 patients in the RT-arm and

was located mainly in the mediastinal (44) and paraaortal (17) regions.

Median RT dose was 36 Gray in median fractions of 1.8 Gray. Toxicities

were generally mild to moderate with only 24 and 8 grade 3 and 4 tox-

icities reported during RT. During long-term follow-up, 23 secondary

malignancies occurred, with RT being no signicant contributing risk

factor (p = 0.504). In the overall study population, patients with RT had

an improved event-free survival (EFS; 63.9 % vs. 46.0 %; p<0.001) and

progression-free survival (PFS; 67.2 % vs. 54.1 %; p = 0.025) but not over-

all survival (OS; p = 0.132) in comparison to non-irradiated patients aer

10 years. For patients with bulky disease, RT resulted in a signicantly

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 231

better outcome (10-year EFS: 64.4 % vs. 34.5 %; p<0.001; 10-year PFS:

68.3 % vs. 47.4 %; p = 0.003; 10-year OS: 71.5 % vs. 59.4 %; p = 0.011),

when compared to patients without RT.

Conclusion: RT improved outcome in young, high-risk patients with

aggressive B-cell lymphoma and bulky disease and should be discussed as

part of the rst line treatment for these patients.

Indication of source:

1 Lancet Oncol 2012;13(12):1250–1259.

2 Lancet Haematol 2021;8(4):e267–e277.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

Lung Cancer

1136

AI-driven, mIF-based cell-omics reveals spatially resolved cell

signature for outcome prediction in NSCLC patients.

Simon Schallenberg1; Gabriel Dernbach1,2; Sharon Ruane2; Cornelius

Böhm2; Lukas Ru2; Kai Standvoss2; Sandip Ghosh2; Marco Frentsch3;

Mihnea P. Dragomir1; Rebecca Fritz1; Ines Koch1; Corinna Friedrich1;

Il-Kang Na3; Sabine Merkelbach-Bruse4; Alexander Quaas4; Nikolaj Frost5;

Kyrill Boschung6; Winfried Randerath6; Georg Schlachtenberger7;

MatthiasHeldwein7; Ulrich Keilholz8; Khosro Hekmat7;

Jens-CarstenRückert9; Reinhard Büttner4; Angela Vasaturo10;

DavidHorst1; Maximilian Alber2; Frederick Klauschen1,11

1Institut für Pathologie der Charite, Berlin, Deutschland

2Aignostics GmbH, Berlin, Deutschland

3Institut für Hämatologie, Onkologie und Tumorimmunologie der Charite,

Berlin, Deutschland

4Institut für Pathologie, Uniklinikum Köln, Köln, Deutschland

5Institut für Infektiologie und Pneumologie der Charite, Berlin, Deutschland

6Bethanien Krankenhaus, Klinik für Pneumologie und Allergologie, Solingen,

Deutschland

7Institut für Thoraxchirurgie, Uniklinikum Köln, Köln, Deutschland

8Comprehensive Cancer Center der Charite, Berlin, Deutschland

9Institut für Thoraxchirurgie der Charite, Berlin, Deutschland

10Ultivue, Cambridge, USA

11Institut für Pathologie der Ludwig-Maximilians-Universität, München,

Deutschland

Background: Lung cancer is the leading cause of cancer death worldwide.

Non-small cell lung cancer (NSCLC) represents about 80% of all lung

cancer cases. e tumor microenvironment (TME) inuences the clinical

outcome, whereby the location and composition of immune cells relates to

their function and activity. erefore, we developed a multiplex immuno-

uorescence (miF)-based, AI-driven approach for spatially resolved TME

characterization at the cellular level and used this to successfully predict

patient survival.

Methods: We collected FFPE tissue and clinicopathological data from

1168 patients with resected NSCLC from Berlin and Cologne. Aer tis-

sue microarray construction, sections were stained with a 12-plex immu-

nouorescence (IF) panel and with hematoxylin, eosin, respectively, and

all stains were scanned and co-registered with single cell accuracy. An

H&E-based tissue segmentation model was trained to detect the dierent

tumor regions: carcinoma, stroma, and necrosis. Next, a nucleus-based

cell detection model, and 12 binary cell classication models were devel-

oped to classify each detected cell by their H&E and miF staining. At last,

we trained a model on the Berlin cohort using the spatially resolved cell

readouts of cell densities in regions, marker expression, cell neighborhood

niches, to predict patient survival on the Cologne cohort.

Result: Our prediction model identied spatially resolved cell signatures

to predict patient survival. e model signicantly improves over the

UICC8 baseline for LUSC (63.6 to 71.5 C-Score) and LUAD (64.5 to 68.9

C-Score) on the hold-out cohort.

Discussion: Our approach illustrates the utility of cell-based spatial anal-

yses and highlights how AI can improve our understanding of TME fea-

tures that underlie clinical outcome.

Conclusion: e combination of our large real-world clinical cohort,

multiplex panel, and automated AI approach enabled the detection of a

specic cell neighborhood signature to predict patient survival, outper-

forming the commonly used UICC8 staging system.

Disclosure Statement: e authors declare the following: Beratungstätigkeit bei der

Aignostics GmbH

965

Real-world data on the eectiveness of a nationwide precision

medicine program for advanced non-small cell lung cancer –

The national Network Genomic Medicine Lung Cancer

Anika Kästner1; Anna Kron2,3; Neeltje van den Berg1; Kilson Moon1;

Matthias Scheer2,3; Gerhard Schillinger4; Natalie Pelusi3,5;

NilsHartmann3,6; Damian Rieke3,7; Susann Stephan-Falkenau3,8;

MartinSchuler3,9; Martin Wermke3,10; Wilko Weichert3,11;

FrederickKlauschen3,12; Florian Haller3,13; Horst-Dieter Hummel3,14;

MartinSebastian3,15; Stefan Gattenlöhner3,16; Carsten Bokemeyer3,17;

IreneEsposito3,18; Florian Jakobs3,19; Christof von Kalle3,20;

ReinhardBüttner3,21; Jürgen Wolf2,3; Wolfgang Homann1

1Institute for Community Medicine, Section Epidemiology of Health Care and

Community Health, University Medicine Greifswald, Greifswald, Deutschland

2Department I of Internal Medicine, Center for Integrated Oncology Aachen

Bonn Cologne Duesseldorf, Lung Cancer Group Cologne, University Hospital of

Cologne, Köln, Deutschland

3National Network Genomic Medicine Lung Cancer, Köln, Deutschland

4AOK Bundesverband, Berlin, Deutschland

5Institute of Pathology, University Hospital Bonn, Bonn, Deutschland

6Institute of Pathology, University Medical Center, Johannes Gutenberg

University Mainz, Mainz, Deutschland

7Charité Comprehensive Cancer Center, Charité Universitätsmedizin Berlin,

Berlin, Deutschland

8Institute of Pathology, Helios Klinikum Emil von Behring, Berlin, Deutschland

9West German Cancer Center, University Hospital Essen, Essen, Deutschland

10Clinic for Internal Medicine I, University Hospital Carl Gustav Carus and

Medical Faculty of the TU Dresden, Dresden, Deutschland

11Institute of Pathology, Technical University of Munich (TUM), München,

Deutschland

12Institute of Pathology, Ludwig-Maximilians-University (LMU), München,

Deutschland

13Institute of Pathology, Friedrich-Alexander University Erlangen-Nuremberg,

University Hospital Erlangen, Erlangen, Deutschland

14Translational Oncology/Early Clinical Trial Unit (ECTU), Comprehensive Cancer

Center Mainfranken and Bavarian Cancer Research Center (BZKF), University

Hospital Würzburg, Würzburg, Deutschland

15Department of Medicine II, Hematology/Oncology, University Hospital

Frankfurt, Frankfurt, Deutschland

16Department of Pathology, University Hospital Giessen and Marburg, Giessen,

Deutschland

17University Cancer Center Hamburg, University Medical Center Hamburg-

Eppendorf, Hamburg, Deutschland

18Institute of Pathology, Heinrich-Heine-University and University Hospital

Duesseldorf, Düsseldorf, Deutschland

19Department of Hematology and Stem Cell Transplantation, Faculty of

Medicine and University Hospital Essen, University of Duisburg-Essen, Essen,

Deutschland

20Berlin Institute of Health at Charité Universitätsmedizin Berlin, Berlin,

Deutschland

21Institute of Pathology, Faculty of Medicine and University Hospital Cologne,

Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Lung

Cancer Group Cologne, University of Cologne, Köln, Deutschland

Background: Despite guideline recommendations, up to 10% of patients

with advanced non-small cell lung cancer (aNSCLC) in Germany still do not

receive any molecular diagnostics. e German national Network Genomic

Medicine Lung Cancer (nNGM) provides comprehensive molecular diag-

nostics and personalized treatment information for patients with aNSCLC.

e primary aim of this study was to determine whether participation in the

precision medicine program (PMP) nNGM improves overall survival (OS).

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts232

Methods: Patients with initial diagnosis of aNSCLC between April 2019

and June 2020 and insurance coverage by AOK (German health insur-

ance) were included in this historical cohort analysis. e nNGM-group

comprised patients who received molecular diagnostics and personalized

treatment information within the nNGM, while the non-nNGM-group

received usual care. Claims data (in- and outpatient AOK data) were pro-

vided for both groups and, for the nNGM-group, were case-specically

merged with electronic health record data from the nNGM.

Result: n=509 patients were included in the nNGM-group and n=7,

213patients in the non-nNGM-group. e OS of the nNGM-group was

signicantly higher compared to the non-nNGM-group (10.5 months vs.

8.7 months, p=0.008, HR=0.84, 95%CI: 0.74-0.95). e 1-year OS rates

were 46.8% in the nNGM-group and 41.3% in the non-nNGM-group.

Patients in the nNGM-group received more frequently rst-line targeted

therapies compared to the non-nNGM-group (nNGM: 8.4%; non-nNGM:

5.1%; p=0.001).

Discussion: As personalized treatment strategies for aNSCLC continue

to advance, oncologists face clinical, nancial, and administrative chal-

lenges. A structured and standardized PMP has the potential to enhance

the implementation of precision medicine in routine care.

Conclusion: We found improved OS and increased use of targeted ther-

apies in aNSCLC patients participating in the nNGM, indicating that a

PMP can facilitate translation of the latest scientic knowledge into rou-

tine care, leading to improved clinical outcomes.

Disclosure Statement: e authors declare no conict of interest.

Poster

Articial Intelligence in Cancer Care and

Diagnostics

1074

Spatial proling of the SCLC tumor microenvironment

dened by high MHC-I expression reveals association with

functionally relevant antigen presentation

Miljenka Vuko1,2; Felix Segerer1,2; Xie Mingchao1;

MonicaAzquetaGavaldon1,2; Andreas Spitzmüller1,2; Harald Hessel1,2;

Marco Testori1,2; Michael Surace1; Mari Heininen-Brown1;

ShashankSaran1; Helen Angell1; Jamie Rodriguez Canales1;

GünterSchmidt1,2; Nicolas Brieu1,2; Hadassah Sade1,2; Carl Barrett1;

Christian Eisen1,2; Markus Schick1,2; Giulia Fabbri1

1AstraZeneca Early Oncology, Oncology R&D, Gaithersburg, USA

2AstraZeneca Computational Pathology, Early Oncology R&D, München,

Deutschland

Background: Small cell lung cancer (SCLC) is an aggressive and largely

immune-cold cancer type, for which chemotherapy combined with

Immuno-oncology (IO) therapies is providing benet only in a subgroup

of patients. One of the established subtypes is characterized by an inamed

immune gene signature and high expression of MHC class I (MHC-I).

Here, we aimed to assess the spatial characteristics of immune cells in the

SCLC “inamed” subtype characterized by high expression of MHC class

I (MHC-I) investigating its role as a potential biomarker.

Methods: We combined a computational pathology approach with mul-

tiplex immunouorescence (mIF) to prole the SCLC tumor microenvi-

ronment. To this end, 126 SCLC FFPE tissue samples were stained with

two mIF panels consisting of six markers each: (A) PanCK, CD8, CD68,

PD-1, PD-L1, and Ki67; (B) CD20, NKp46, CD1c, CD66b, ICOS, and

FOXP3. Based on this, we investigated the location and phenotype of each

cell within the tumor center, the stroma and tumor epithelium.

Result: We observed higher densities of CD8+ cytotoxic, FOXP3+ reg-

ulatory, and ICOS+ T-cells in the tumor center of MHC-I high cases.

Considering the role of MHC-I in antigen presentation and T-cell acti-

vation, we investigated the proportion of CD8;PD-1;Ki67+ T-cells out of

all CD8+ cells and found the proportion to be signicantly higher in the

parenchyma of MHC-I high cases. is eect was not observed in cases

with MHC-I H-score of less than 30.

Discussion: e high proportion of triple-positive CD8+ T-cells present

in the tumor parenchyma and absent in the stroma of MHC-I high cases,

indicate an association with functionally relevant presentation of tumor

antigens by MHC-I on SCLC tumor cells.

Conclusion: We utilized computational pathology to comprehensively

prole the composition and spatial arrangement of the TME in inamed

SCLC cases dened by high MHC-I expression. Our ndings provide the

functional rationale for MHC-I as a biomarker for a potentially increased

response to IO therapies.

Disclosure Statement: e authors declare the following: Active or Previous

employees of AstraZeneca and may own stock or stock options.

1079

Discovery of predictive biomarkers for precision immuno-

oncology using computational pathology-based digital twins

Günter Schmidt1; Jan Lesniak1; Thomas Kunzke1; Federico Pollastri1;

Markus Schick1; Johannes Zimmermann1; Ross Stewart2

1AstraZeneca Computational Pathology GmbH, Early Oncology R&D, München,

Deutschland

2AstraZeneca Oncology R&D, Oncology Translational Medicine, Cambridge,

United Kingdom

Purpose: Exploratory data from single-arm PhI/II clinical trials provide

a unique opportunity for predictive biomarker discovery, however, the

absence of a control arm poses a signicant risk to subsequent signicant

biomarker-driven PhIII trials.

Methods: A Digital Twin is the computational description a real patient

based on their clinical data, including digitized whole slide images (WSI) of

histopathology baseline samples. Here, we demonstrate the generation of a

virtual randomized PhIII clinical trial (vPhIII) via Digital Twins and their

application for predictive biomarker discovery in Non Small Cell Lung

Cancer (NSCLC). To this end, WSI of NSCLC tissue samples from a PhI/

II trial (NCT01693562) and the PhIII trial MYSTIC (NCT02453282)were

digitally analyzed with quantitative continuous scoring of PD-L1 protein

expression (PD-L1 QCS). For each PhI/II patient, its Digital Twin was

generated by identifying the most similar matching patient in the PhIII

control arm based on their image features.

Result: Screening PD-L1 QCS features for their longest median OS time

(mOS) benet in the QCS-positive vPhIII sub-group, the feature provid-

ing longest mOS benet was evaluated in the real PhIII cohort. In total,

N=121 Digital Twins were generated as vPhIII cohort, while average mOS

benet analysis for each feature indicated that the 20% quantile of PD-L1

tumor cell expression provided optimal stratication.

Discussion: e mOS comparison of the real PhIII with the vPhIII

showed the OS benet from ICI treatment has been underestimated by

the Digital Twins model. Although the selected QCS feature did not indi-

cate signicant treatment benet in the vPhIII, a retrospective analysis of

MYSTIC hints towards benecial patient stratication.

Conclusion: Digital Twins based on imaging data are a promising approach

to generate virtual randomized and biomarker stratied PhIII trials based

on single-arm PhI/II and historic Standard-of-Care data. is proof-of-con-

cept study demonstrates technical feasibility of this innovative methodology.

Disclosure Statement: e authors declare the following: Active or Previous

employees of AstraZeneca and may own stock or stock op-tions.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 233

1140

Multiphase modeling and patient-specic simulation of

tumors in soft tissue

Marlon Suditsch1; Tim Ricken1; Arndt Wagner2

1Institut für Statik und Dynamik der Luft- und Raumfahrtkonstruktionen,

Universität Stuttgart Campus Vaihingen, Stuttgart, Deutschland

2Insitut für Mechanik (Bauwesen), Universität Stuttgart Campus Vaihingen,

Stuttgart, Deutschland

Background: In critical tissue areas such as in the brain, additional

chemo- and radiation therapy is essential in conjunction with resection of

a tumor or is the only possible form of a therapy at all. In this regard, the

decision on a suitable form of therapy is extremely challenging. e aim

of the presented work is to develop a simulation tool called OncoFEM that

supports clinicians in this decision-making process by combining data-

and knowledge-driven approaches and predicting a tumor evolution from

inputs of imaging techniques such as magnetic resonance imaging.

Methods: Relevant information of the microstructural composition of

the healthy tissue and the position of the tumor are identied with dif-

ferent machine learning tools, such as convolutional neural networks.

Prepared referential states are simulated with the relevant processes by

embedding a continuum-mechanical, multi-phasic model in the frame-

work of the eory of Porous Media, cf. Wagner [1]. Based on Wolf et al.

[2], the tumor is divided into its necrotic and active solid core, which is

enclosed by an edema in the surrounding tissue, that consists of an extra-

cellular matrix and interstitial uid. e latter includes additive compo-

nents, e.g. glucose, growth factors or an applied therapeutic agent

Results and Discussion: In addition to the basic eects of diusive

spreading and the mass eect, actual situations from the tumors emer-

gence growing up to the pre-operative state, its resection and the applica-

tion of a drug can be simulated with a well parametrized model.

Conclusion: By consideration of multiple solids and uid-resolved

additive components, relevant clinical questions can be studied from

multi-scientic perspectives.

Indication of source:

1 A. Wagner. Continuum mechanics of multicomponent materials: modelling,

numerics and applications for biological materials in the framework of the

theory of porous media. Habilitation. University of Stuttgart (2021)

2 K. J. Wolf et al.. Dissecting and rebuilding the glioblastoma microenvironment

with engineered materials. Nature Reviews Materials (2019) 10: 615-668

Disclosure Statement: e authors declare no conict of interest.

Biomarker

1073

Optimizing Genomic Analyses in Challenging FFPE Samples

Nicolas Casadei1; Michaela Pogoda1; Florian Harmuth1; Jakob Admard1;

Alexander Ott1; Tobias Haack1; Stephan Ossowski1; Sorin Armeanu-

Ebinger1; Christopher Schroeder1; Olaf Riess1

1Institute for Medical Genetics and Applied Genomics, Tübingen, Deutschland

Background: Advances in genomics, particularly through methods such

as whole genome sequencing and whole exome sequencing, have funda-

mentally changed the study of somatic mutations that are essential for

understanding tumor biology and adjusting therapeutic interventions in

the eld of personalized medicine.

Methods: Although formalin-xed paran-embedded tissue is com-

monly used as the primary source of tumor material for histological anal-

ysis, analyzing genomic nucleic acids extracted from such samples poses

signicant challenges including fragmented molecules, chemical modi-

cations and high levels of cross-linking to proteins. At the same time,

advances in genomic library preparation aim to simplify procedures and

reduce costs by combining multiple enzymatic steps into a single reaction,

but this unication presents an additional challenge in maintaining rigor-

ous quality for low-quality DNA and RNA.

Result: Our study addresses these diculties by ne-tuning RNA and

DNA sequencing protocols and introducing strategic adaptations to

improve library preparation yields and reduce artefacts. Specically, we

describe adjustments made to an RNA sequencing protocol using ribo-

somal depletion, a whole genome protocol with library amplication, and

an exome enrichment protocol to enhance the sequencing outcomes.

Discussion: e study provides detailed insights and a valuable frame-

work for troubleshooting suboptimal protocols in genomics laboratories

working with low-quality DNA and RNA

Conclusion: By outlining the critical steps for monitoring and improve-

ment, our ndings aim to strengthen the robustness of genomic analyses

in challenging sample contexts.

Disclosure Statement: e authors declare no conict of interest.

Breast Cancer

1053

Phase III study of adjuvant ado-trastuzumab emtansine vs

trastuzumab for residual invasive HER2-positive early breast

cancer after neoadjuvant chemotherapy and HER2-targeted

therapy: KATHERINE nal IDFS and updated OS analysis

Michael Untch1; Sibylle Loibl2; Max S. Mano3; Chiun-Sheng Huang4;

Eleftherios P. Mamounas5; Norman Wolmark6; Adam Knott7;

AsnaSiddiqui7; Thomas Boulet8; Beatrice Nyawira8; Eleonora Restuccia8;

Charles E. Geyer6

1AGO-B and Helios Klinikum Berlin Buch, Berlin, Deutschland

2German Breast Group, Neu-Isenburg, Germany, Centre for Haematology and

Oncology Bethanien, Goethe University, Frankfurt, Germany

3Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil

4National Taiwan University Hospital and National Taiwan University College of

Medicine, Taipei, Taiwan

5NSABP Foundation, Pittsburgh, PA and Orlando Health Cancer Institute,

Orlando, FL, USA

6NSABP Foundation and University of Pittsburgh/UPMC Hillman Cancer Center,

Pittsburgh, PA, USA

7Roche Products Limited, Welwyn Garden City, UK

8F. Homann-La Roche Ltd, Basel, Switzerland

Background: Patients with HER2-positive early breast cancer (EBC) who

have residual invasive disease aer neoadjuvant chemotherapy [NACT]

+ HER2-targeted therapy have a high risk of recurrence and death. e

standard of care when KATHERINE was designed was continuation of the

same HER2-targeted therapy in the adjuvant setting.

Methods: KATHERINE (NCT01772472) is a phase III, open-label, global

study of patients with centrally conrmed, HER2-positive (IHC 3+ or in

situ hybridization-positive) primary BC (T1–4, N0–3, M0) who received

NACT + HER2-targeted therapy, which had to include a taxane and tras-

tuzumab, followed by surgery, with residual invasive disease in the breast

and/or axillary lymph nodes. Within 12 weeks of surgery, patients were

randomized 1:1 to T-DM1 (3.6 mg/kg intravenously [IV] every 3 weeks

[q3w]) or trastuzumab (6 mg/kg IV q3w) for 14 cycles.

Result: With a median follow-up of 8.4 years (101 months), T-DM1 sus-

tained the improvement in IDFS compared to trastuzumab (hazard ratio

[HR] 0.54; 95% condence interval [CI] = 0.44, 0.66; p < 0.0001). 7-year

IDFS rates were increased from 67.1% with trastuzumab to 80.8% with

T-DM1; a dierence of 13.7%. At clinical cuto for the nal IDFS analysis,

215 deaths had been reported. T-DM1 signicantly reduced the relative

risk of death by 34% compared with trastuzumab (HR 0.66; 95% CI = 0.51,

0.87; p = 0.0027). 7-year OS rates were increased from 84.4% with trastu-

zumab to 89.1% with T-DM1; a dierence of 4.7%. OS and IDFS benets

were seen across key subgroups. A low incidence of adverse events (AEs)

was observed during the post-treatment period.

Discussion: T-DM1 signicantly improved OS in patients with HER2-

positive EBC with residual invasive disease aer neoadjuvant therapy. e

IDFS benet of T-DM1 was sustained in the intention-to-treat population

with longer follow-up, and no new safety issues emerged.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts234

Conclusion: T-DM1 is the rst therapy to show improved survival

post-surgery in patients with HER2-positive EBC with residual invasive

disease aer neoadjuvant therapy.

Prev. presented at SABCS, Loibl et. al

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

1058

Blood test instead of mammography? Validation of

CpGmarkers on precursor lesions and early breast cancer

resections

Sandra Krüger1; Hans-Michael Behrens1; Fritz K.W. Schäfer2;

ChristophRöcken1

1Department of Pathology, UKSH Campus Kiel, Kiel, Deutschland

2Department of Gynecology and Obstetrics, UKSH Campus Kiel, Kiel,

Deutschland

Background: Although the introduction of mammography made a sig-

nicant contribution to breast cancer (BC) screening, it comes with

severe limitations. Only 50% of eligible women make use of this screening

method as they might fear radiation, it lacks sensitivity for patients with

dense breast tissue, and it disregards patients younger than 50, which make

up to 25% of BC cases[1]. To reach more patients with a widely applicable

screening method, we investigated if four CpG markers known to reliably

detect advanced BC[2] can distinguish B3 lesions from early malignancies.

Methods: Pyro sequencing and droplet digital PCR assays were devel-

oped to screen 248 formalin-xed and paran-embedded (FFPE) early

BCs, 89 ductal carcinomas in situ (DCIS) and 49 B3 lesions. Furthermore,

promoter CpG sites of the aected four genes were examined and their

protein products were analyzed using immunohistochemistry.

Result: ree out of four CpG markers could signicantly distinguish B3

lesions from early malignancies. Additional CpG sites were identied,

whose methylation dierentiated benign from malignant. Furthermore,

both promoter and intragenic methylation could be linked to protein

expression, thereby identifying new therapeutic targets.

Discussion: Our PCR-based assays conrmed that CpG markers are able

to detect advanced BC and above that, to detect early stage cancer includ-

ing DCIS. However, the data collected on articially modied FFPE DNA

of tumor resections must be validated on cell-free DNA in further studies,

to provide a screening tool applicable for blood samples.

Conclusion: CpG markers have great potential for BC screening and

PCR-based assays present a cost-eective method for this purpose. In

addition, methylome and corresponding protein analyses can identify

further therapy and prognostic targets.

Indication of source:

1 Kramp, L-J et al. 2021 DOI: 10.1007/s00432-021-03841-x

2 Zhang et al., 2021 DOI: 10.1038/s41523-021-00316-7

Disclosure Statement: e authors declare no conict of interest.

1095

Genome Sequencing oers innovative answers for current

issues like personnel shortage, increasing healthcare costs

and diagnostics gap in HBOC

Dennis Witt1; Ulrike Faust1; Kristin Bosse1; Cristiana Roggia1; Janna Witt1;

Silja Gauss1; Antje Stäbler1; Marc Sturm2; German Demidov2;

TobiasHaack1; Stephan Ossowski2; Olaf Riess1; Christopher Schroeder1

1Institut für Medizinische Genetik und Angewandte Genomik,

Universitätsklinikum Tübingen, Tübingen, Deutschland

2NGS Competence Center Tübingen, Universitätsklinikum Tübingen, Tübingen,

Deutschland

Background: Hereditary Breast and Ovarian Cancer (HBOC) syndrome

is a frequent cancer predisposition and substantially increases cancer

risks in aected patients. Genetic testing typically targets 10-19 risk genes

and causative variants are identied in less than 20% of cases. Due to this

diagnostic gap new sequencing techniques, like genome sequencing (GS),

promise identication of new genetic markers for predictive testing and

clinical management.

Methods: e study involved 819 breast or ovarian cancer patients with

suspected HBOC familial history and 4810 healthy control patients.GS

was conducted in our accredited lab following standard procedures.

Results: GS produced >899 million reads, with an average depth of 41.16x.

Coverage of risk genes signicantly outperformed exome sequencing

(99.34% vs. 95.63%, p<0.001). GS achieved over 99% sensitivity and PPV for

SNVs, and over 95% for SVs. GS reduced MLPA testing by approximately

93% and allowed a higher annual sample throughput (373 vs. 322 samples).

Causative variants were found in 12.7% of cases across 9 HBOC genes.

Simultaneous detection of polygenic risk scores (using PRS313) suggested a

potential explanation for additional breast cancer cases. e in-depth char-

acterization of two complex structural variants aecting BARD1 and ATM

conrmed the advantages of GS over conventional testing methods.

Discussion: Current HBOC genetic testing, combining various methods,

is streamlined by GS, enhancing diagnostic yield by identifying additional

structural variants. PRS313 might explain up to an additional 20% of

cases. GS signicantly improves diagnostic capabilities for larger patient

cohorts. In conclusion, GS allows to eciently extend the diagnostic

capacity for larger patient cohorts.

Disclosure Statement: e authors declare no conict of interest.

Cancer of Unknown Primary (CUP)

995

Primary analysis of ecacy and safety in the CUPISCO trial:

A randomised, global study of targeted therapy or cancer

immunotherapy guided by comprehensive genomic proling

(CGP) vs platinum-based chemotherapy (CTX) in newly

diagnosed, unfavourable cancer of unknown primary (CUP)

Alwin Krämer1; Linda Mileshkin2; Tilmann Bochtler3; Chantal Pauli4;

Gonzalo Durán-Pacheco5; Cagatay Arslan6; Frédéric Bigot7;

NasséraChalabi5; Natalie Cook8; Antoine Italiano9; Ferran Losa10;

JulianaJanoski de Menezes11; Chantal Michaud5; Mustafa Özgüroğlu12;

Roberto A. Pazo-Cid13; Jerey S. Ross14; Kai-Keen Shiu15; Michael Stahl16;

Marlene Thomas5; Holger Moch4

1German Cancer Research Center (DKFZ) and University of Heidelberg,

Heidelberg, Germany

2Peter MacCallum Cancer Centre and University of Melbourne, Melbourne,

Australia

3German Cancer Research Center (DKFZ), University of Heidelberg and National

Center for Tumor Diseases, Heidelberg University Hospital, Heidelberg, Germany

4University of Zürich and University Hospital Zürich, Zürich, Switzerland

5F. Homann-La Roche Ltd, Basel, Switzerland

6Medical Park İzmir Hospital, İzmir, Turkey

7Institut de Cancérologie de l’Ouest, Nantes-Angers, France

8The University of Manchester and the Christie NHS Foundation Trust,

Manchester, UK

9Institut Bergonié, Bordeaux, France

10Hospital de Sant Joan Despí Moisès Broggi, ICO Hospitalet, Barcelona, Spain

11Centro Pesquisa Integrado em Oncologia, Porto Alegre, Brazil

12Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey

13Miguel Servet University Hospital, Zaragoza, Spain

14Foundation Medicine, Inc./ SUNY Upstate Medical University, Cambridge/

Syracuse, USA

15UCL Cancer Institute, London, UK

16Evang. Kliniken Essen-Mitte, Essen, Germany

Purpose: With platinum-based CTX, prognosis of patients (pts) with

unfavorable CUP is poor; however, CGP may inform treatment strate-

gies based on cancer genomics. e CUPISCO trial (NCT03498521)

compared the ecacy and safety of molecularly guided therapy (MGT) vs

standard platinum-based CTX in pts with newly diagnosed, unfavorable,

non-squamous CUP.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 235

Methods: Pts had central eligibility review-conrmed CUP with ≥1 mea-

surable lesion (investigator-assessed via RECIST v1.1). All had tumor

tissue and/or blood CGP (Foundation Medicine, Inc.). Aer 3 induction

CTX cycles, pts with disease control were randomized 3:1 to MGT (inves-

tigator’s choice from 12 regimens aer molecular tumor board advice) or

continuation of CTX, stratied by gender and response to induction CTX.

e primary endpoint was progression-free survival (PFS). Secondary

endpoints included overall survival (OS), objective response rate (ORR),

duration of response (DoR) and disease control rate (DCR). Safety was

also assessed. Exploratory endpoints included quality of life (QoL).

Result: From Jul 2018–Dec 2022, 436 pts were randomized: 326 to MGT;

110 to CTX. Median PFS (intent-to-treat population) was 6.1 months

(95% condence interval [CI] 4.7–6.5) with MGT vs 4.4 months (4.1–5.6)

with CTX (hazard ratio [HR] 0.72; 95% CI 0.56–0.92; P=0.0079). Median

OS was 14.7 (95% CI 13.3–17.3) vs 11.0 months (9.7–15.4), respectively

(HR 0.82; 95% CI 0.62–1.09; P=0.1779), though OS data were immature at

cuto. ORR was 9.6% (95% CI 2.4–16.8, P=0.0141) in favor of MGT, with

similar DoR in each arm (HR 0.95; 95% CI 0.33–2.72). DCR was 4.7%

(95% CI –6.4–15.9; P=0.3922) in favor of MGT. Adverse event rates were

generally similar with MGT vs CTX; no dierence in QoL was observed.

Discussion: In pts with newly diagnosed, unfavorable, non-squamous

CUP who responded to induction CTX, CGP with MGT improved PFS

compared to CTX continuation.

Conclusion: Early CGP and MGT should be considered the new standard

of care for these pts.

Previously presented at ESMO, LBA16, Linda Mileshkin et al. - Reused with

permission

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

Central Nervous System

1143

Real world experience with TTFields in glioma patients with

emphasis on therapy usage

Claudius Jelgersma1; Joan Alsolivany1; Gülsüm Akkas1; David Wasilewski1;

Bastian Gastl2; Martin Misch1; David Kaul3; Lars Bullinger4; Peter Vajkoczy1;

Julia Sophie Onken1

1Charité - Universitätsmedizin Neurochirurgie, Berlin, Deutschland

2Novocure GmbH, München, Deutschland

3Charité - Universitätsmedizin Radioonkologie und Strahlentherapie, Berlin,

Deutschland

4Charité - Universitätsmedizin Hämatologie, Onkologie und Tumorimmunologie,

Berlin, Deutschland

Background: Tumor Treating Fields (TTF) therapy, an adjunctive treat-

ment for high-grade tumors, gained prominence following the 2017 EF-14

trial. It enhances outcomes in progression-free survival (PFS) and overall

survival (OS) when used over 18 hours daily (75% usage). EF-14’s post-

hoc analysis shows over 90% usage oers additional benets, whereas it

showed no eect at all below 50% usage. Given the cost-intensive nature

and signicant constraints associated with the therapy, our objective is to

generate real-world data on therapy usage through a retrospective analysis

at a high-throughput academic center.

Methods: From June 2015 to February 2022, 113 patients with high-grade

glioma received TTFields, with 8 discontinuing within 2 months and

excluded from further analysis.

Result: e average age of patients was 49.6 years; 75.2% began therapy

with their rst-line treatment, including 27.6% who started TTFields

simultaneously with the initial temozolomide cycle. 15.2% started TTFields

in the 2nd-line and 9.5% in the 3rd-line setting. e average therapy dura-

tion was 9.3 months, with a 65.5% mean usage. Usage peaked in the rst

3 cycles (77.7%, 72.3%, and 71.6%), then gradually declined over time.

Linear regression found no predictors of usage. Upon recurrence, 55% of

patients continued TTFields treatment. However, the patients exhibit a

signicant drop in usage rates to averaging 52.3%. Interestingly, no eect

on usage rate was observed before the diagnosis of a tumor recurrence was

communicated.

Conclusion: is study reveals that actual usage falls below the recom-

mended 75%, underscoring the need for adherence monitoring and

strategies to improve long-term commitment to TTFields in managing

high-grade gliomas.

Disclosure Statement: e authors declare the following: Drittmittel Novocure,

Reisekostenunterstützung

1103

Senescence is the main trait induced by temozolomide in

glioblastoma cells

Lea Beltzig1; Christian Schwarzenbach1; Petra Leukel2; Clemens Sommer2;

Alessandro Tancredi3; Monika Hegi3; Markus Christmann1; Bernd Kaina1

1Universitätsmedizin, Institut für Toxikologie, Mainz, Deutschland

2Universitätsmedizin, Institut für Neuropathologie, Mainz, Deutschland

3Neuroscience Research Center and Neurosurgery, Lausanne University

Hospital, Epalinges, Schweiz

Background: Gold standard in the treatment of glioblastoma (GBM) is

radio-chemotherapy, using the alkylating agent temozolomide (TMZ).

TMZ methylates the tumor cell DNA giving rise to N-alkylations and

O6-methylguanine (O6MeG). While the N-alkylated DNA bases are

removed from DNA by base excision repair (BER), O6MeG is repaired

by MGMT, which is lacking in about 40% of glioblastomas (GBM). If not

repaired, O6MeG results in secondary DNA damage that trigger the DNA

damage response (DDR). is leads to activation of the apoptotic and also

the autophagy and cellular senescence (CSEN) pathway. Here we charac-

terized the CSEN pathway induced by TMZ in more detail.

Methods: Apoptosis and CSEN were measured by ow cytometry; CSEN

in specimens were detected by immunohistochemistry.

Result: Analysis of long-term (10d) TMZ treated cells show nearly 90%

of senescent cells, a high level of trimethylated H3K9 and H3K27, high

amounts of DSBs outside of telomers and a sustained activation of the

DDR by upregulation of the p53-p21 axis. TMZ-induced GBM cells exhibit

the senescence-associated secretory phenotype (SASP): they secreted

proinammatory cytokines such as interleukin-1 (IL-1), IL-6 and IL-8.

Senescent cells were also found in GBM specimens, that displayed higher

levels of CSEN in recurrences compared to the primary tumour. To further

elucidate the role of O6MeG in senescence induction following TMZ treat-

ment, we used a tet-on system to induce MGMT following TMZ treatment.

Upregulation of MGMT 1-2d aer TMZ treatment completely abrogated

CSEN induction, while MGMT upregulation >3d following TMZ treat-

ment had no eect. Induction of MGMT in senescent cells did not reduce

the senescence level.

Discussion: ese results revealed that senescence is the main response

of TMZ-treated GBM cells and indicate that senescence is a key pathway

triggered by adjuvant radio-chemotherapy of GBM.

Conclusion: ese results indicate, that O6MeG is absolutely essential for

the induction, but not maintenance of the senescence state.

Disclosure Statement: e authors declare no conict of interest.

1034

Analysis of the immune microenvironment of chordoma

tumors

Zhenlin Wang1; Andreas Unterberg1; Christel Herold-Mende1; Rolf Warta1

1The Department of Neurosurgery, University Hospital Heidelberg, Heidelberg,

Deutschland

Background: Chordoma is highly recurrent due to the poor en-bloc resec-

tion rate and low sensitivity to conventional chemotherapy and radiother-

apy. e objective of the study is to explore potential markers for prognosis

and immunotherapy of chordoma.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts236

Methods: 53 chordoma patients who underwent resection surgery at

the Department of Neurosurgery, University Hospital Heidelberg were

included. Cryopreserved samples were utilized for immunouorescence

(IF) staining of tumor-associated macrophage (TAM-general: CD68+,

M2-like TAM: CD68+/CD163+), tumor-inltrating T lymphocyte (TIL-

general: CD3+, cytotoxic T cell: CD3+/CD8+, regulatory T cell: CD3+/

CD8-/FoxP3+), and tumor cells (pan-cytokeratin+). e localization and

quantity of cells have been assessed using the semi-automated analysis

soware, StrataQuest.

Result: 53 samples were analyzed including 25 primary tumors (25%),

28 males (56%), 37 clivus-located tumors (70%), 15 so-tissue inltrating

tumors (28%), and 34 receiving postoperative radiotherapy (64%). e

median age was 40 years (range: 2-77) with a median progression-free

survival (PFS) of 14 months (range: 0-176). e IF staining revealed a sig-

nicant presence of inltrating immune cells with median percentages of

3.67% TAMs (0.34-25.55%), 2.29% M2-like TAMs (0.13-11.03%), 6.28%

TILs (1.34-31.29%), 1.26% cytotoxic T cells (0.18-8.35%), and 0.16% reg-

ulatory T cells (0.04-0.85%). Furthermore, a higher inltration level of

TAM or cytotoxic T cell was associated with a better PFS. Moreover, a

higher intratumoral TAM inltration was signicantly associated with an

increased OS in the group of newly diagnosed chordomas.

Discussion: As in the majority of other tumor entities, high TAM inl-

tration is associated with unfavorable outcomes, our results may indicate

novel mechanisms in chordoma and require more in-depth analysis.

Conclusion: e association of high TAM inltration and prolonged PFS

indicates that chordoma patients might benet from immune-activating

therapies.

Disclosure Statement: e authors declare no conict of interest.

Endocrine Tumors

1020

Safety and ecacy of everolimus (EVE) as second–line

treatment in neuroendocrine neoplasms G3 (NEN G3) - an AIO

phase II study (EVINEC)

Marianne Pavel1; Günter Klöppel2; Ludwig Fischer von Weikersthal3;

DieterHörsch4; Karin Mayer5; Jörg Schrader6; Marinela Augustin7;

MarinoVenerito8; Katrin Krause9; Leonidas Apostolidis10

1Universitätsklinik Erlangen, Gastroenterology and Hepatology, Endocrinology

Dept, Erlangen, Deutschland

2Technical University Munich, Institute of Pathology, München, Deutschland

3Klinikum St. Marien Amberg, Onkologisches Zentrum, Amberg, Deutschland

4Zentralklinik Bad Berka, Department of Internal Medicine/Gastroenterology

and Endocrinology, Bad Berka, Deutschland

5Universitätsklinikum Bonn, Department of Haematology and Oncology, Bonn,

Deutschland

6Universitätsklinikum Hamburg Eppendorf, Center of Internal Medicine,

Hamburg, Deutschland

7Klinikum Nürnberg, Clinic for Internal Medicine, Centre for Oncology/

Haematology, Nürnberg, Deutschland

8Universitätsklinik Magdeburg, Department of Gastrointestinal Oncology,

Magdeburg, Deutschland

9AIO-Studien-gGmbH, Project Management Sponsor, Berlin, Deutschland

10National Center for Tumor Diseases (NCT) Heidelberg, Department of Medical

Oncology, Heidelberg, Deutschland

Background: Well-di neuroendocrine tumors G3 (NET G3) represent a

separate entity from poorly di neuroendocrine carcinoma (NEC). While

platinum-based 1st line CTx is established in adv NEC, there is limited

ecacy of 2nd line CTx, therapy of NET G3 is still under investigation.

Since the mTOR inhibitor EVE mediates disease stabilization in pts with

NET G1/G2, and data on targeted therapy in NEN G3 were lacking, we

investigated EVE as 2nd line trt in NEN G3.

Methods: EVINEC was a prospective, single-arm, phase 2 study planned

to enroll 40 pts with hist conf NET G3/NEC G3 with progressive disease

on/aer platinum-based CTx. Trt was EVE 10 mg/day. Prim endpoint was

safety. Central review was performed by a highly experienced pathologist.

Result: 39 pts were initially found eligible. For 3 of these, central review

determined their tumors not to be NEN. Of the remaining 36, 13 were

NET G3, 14 NEC, and 9 mixed neuroendocrine-nonneuroendocrine neo-

plasms (MiNEN). MiNEN pts remained on study since NEN components

were NEC G3.

Most frequent EVE-related AEs were stomatitis (39%), fatigue (31%),

diarrhea (28%), nausea (25%), decr appetite (22%), epistaxis (19%), rash

(19%), decr weight (17%), back pain (14%), dry mouth (14%), aphthous

ulcer (11%), dermatitis acneiform (11%), and pyrexia (11%). 2 pts (6%)

were aected by pneumonitis, and trt-related infections were reported for

5 pts (14%).

Median PFS and OS for the Per Protocol (PP) population were 2.2 and

12.0mo, in NET G3 5.2 (range 0.7-18.8) and 23.9 mo, in NEC 1.8 and 5.6mo,

and in MiNEN 2.2 and 7.0 mo, respectively. 6 pts were excluded from the

PP set due to short trt duration or lack of ecacy assessment.

Conclusion: No clinically relevant safety signals for EVE aer prior plat-

inum-based therapy in NEN G3 were identied. e data support e-

cacy in NET G3 but insucient activity in NEC or MANEC. More data

are warranted from prospective trials in NET G3 to address EVE ecacy

compared to other trts.

Study sponsored by AIO-Studien-gGmbH, supported by a grant from Novartis.

Previously presented at ESMO Congress 2023, Abstract 1708, Marianne Pavel et al

Disclosure Statement: e authors declare no conict of interest.

Epidemiology

984

Prevalence of polycythemia vera, cytoreductive treatment,

and thromboembolic events in aected patients: a study

based on longitudinal German health claims data

Karina Manz1; Anja Mocek1; Bashar Morouj2; Katharina Merker3;

MarcFeuerbach3; Ariane Höer1; Valeria Weber1; Raeleesha Norris2;

Susanne Großer3; Frank Andersohn4; Haifa Al-Ali5

1IGES Institut GmbH, Berlin, Deutschland

2InGef – Institut für angewandte Gesundheitsforschung Berlin GmbH, Berlin,

Deutschland

3Novartis Pharma GmbH, Nürnberg, Deutschland

4Frank Andersohn Consulting & Research Services, Berlin, Deutschland

5Universitätsklinikum Halle, Halle (Saale), Deutschland

Background: Data on prevalence and treatment of polycythemia vera (PV)

in Germany are scarce. Guidelines recommend cytoreductive therapy for

high-risk PV (biologic age ≥60 years or history of thromboembolic event

[TE]). Second-line therapy is indicated in case of intolerance/resistance

(IT/R) to rst-line therapy.

Methods: We performed an observational study based on anonymized

claims data from the InGef database (years 2016-2021). Patients with

prevalent PV were identied using dened diagnosis, therapy, and physi-

cian specialty codes. Patients aged ≥60 years or with TE in the respective

year or in the previous 2 years were considered high-risk. We assessed the

share of patients with prescriptions for cytoreductive drugs. Using dened

diagnosis and therapy codes, we identied patients treated with hydroxy-

urea (HU) “only” (= no ruxolitinib [RUX]) and signs of IT/R. We ana-

lyzed the occurrence of TEs over a period of 1 to 3 years among prevalent

patients on continuous treatment (Tx) with HU and signs of IT/R (= HU

cohorts) and those on continuous RUX-Tx (= RUX cohorts).

Results: Extrapolated to the adult German population, the prevalence of

PV for 2021 was 28.6/100,000. 83.2 % of patients were high-risk. 46.3 %

of these patients received no cytoreductive Tx, 41.2 % HU only (of which

63.2 % showed signs of IT/R), and 13.8 % RUX. e RUX cohorts tended

to be younger and healthier than the HU cohorts. TEs were more common

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 237

in the HU cohorts (45.7 % had ≥1 TE within 1 year, 56.3 % had ≥1 TE

within 3 years) than in the RUX cohorts (29.1 % and 35.8 %, respectively).

Discussion: A large share of patients treated with HU show signs of IT/R.

Almost 50 % of high-risk patients received no cytoreductive Tx. In prac-

tice, it appears that younger and healthier patients are more likely to be

switched from HU to RUX. TEs seem to be more common in patients on

continuous Tx with HU only and signs of IT/R.

Conclusion: Our study provides recent insights into the prevalence and

the Tx situation of PV in Germany. Our results suggest that adherence to

Tx guidelines for high-risk PV is suboptimal. is may lead to otherwise

preventable TEs.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed. e study was funded by Novarits Pharma GmbH.

Gastrointestinal Cancer: Colorectal

1015

“Early-onset” colorectal cancer: Perioperative outcome and

analysis of patients’ demographics in a surgical cohort of the

DGAV StuDoQ database

Ulrich Wirth1; Josene Schardey1; Sezal Panchal2; Carsten Klinger2;

Christoph-Thomas Germer3; Dimitrios Pantelis4; Nico Schäfer5;

ChristophReißfelder6; Bernard W. Renz1; Joachim Andrassy1; Jens Werner1;

Florian Kühn1

1LMU Klinikum, München, Deutschland

2DGAV, Berlin, Deutschland

3Universitätsklinikum Würzburg, Würzburg, Deutschland

4Universitätsklinikum Bonn, Bonn, Deutschland

5Klinikum Leverkusen, Leverkusen, Deutschland

6Universitätsklinikum Mannheim, Mannheim, Deutschland

Background: ere has been a signicant increase in the incidence of

colorectal cancer (CRC) in patients under the age of 50, which is also

referred to as “early-onset” CRC (EO-CRC). Our aim was to compare

tumor-related and perioperative data between patients with EO-CRC and

“average-onset” CRC (> 50 years; AO-CRC) in a large cohort of surgical

patients.

Methods: e StuDoQ database of the DGAV for colorectal cancer sur-

gery with a total of 66,712 documented cases from 2013 to 2022 was avail-

able. 4,137 cases were excluded due to incomplete data. e remaining

62,575 cases were analyzed comparatively according to tumor-related

and perioperative data between EO-CRC (4,101) vs. AO-CRC (58,474)

groups.

Result: e mean age in the groups was 43.58 ± 6.4 and 71.77 ± 10.1 years.

Tumor location was signicantly dierently distributed with a higher

pro-portion of rectal and le-sided cancer (χ2: p<0.001) in the EO-CRC

group. e number of neoplastic lymph nodes was signicantly higher in

the EO-CRC group (p<0.001). Patients with EO-CRC were signicantly

more likely to have metastases at the time of surgery than patients with

AO-CRC (χ2: p<0.001). In the EO-CRC group, MSI examination (χ2:

p<0.001) and genetic counseling were signicantly more frequent (29.2%

vs. 3.5%; χ2: p<0.001). As expected, family history was signicantly more

oen positive in the EO-CRC group (χ2: p<0.001). Complications such as

post-operative bleeding (χ2: p=0.01), postoperative ileus (χ2: p=0.29) and

wound infections (χ2: p<0.001) occurred less frequently in the EO-CRC

group. However, anastomotic leakage occurred signicantly more fre-

quently in the EO-CRC group (χ2: p<0.001).

Discussion: ere are clear dierences in terms of tumor-related data

between the EO-CRC and AO-CRC groups. Furthermore, there are sig-

nicant dierences in terms of perioperative complication rates.

Conclusion: ere are relevant dierences between patients with EO-CRC

and AO-CRC, which should be taken into account in daily patient care.

Disclosure Statement: e authors declare no conict of interest.

1055

Real world data of early-onset colon cancer (EO-CC) from the

AIO Colopredict Plus (CPP) Registry: Clinical and molecular

characteristics, treatment and outcome

Ira Ekmekciu1; Doreen-Maria Gisder2; Iris Tischo2; Jens Christmann2;

InkeFeder2; Elena Schlageter1; Sarah Wisser2; Celine Lugnier1; Anna-

LenaKraeft1; Robin Denz3; Heiner Wolters4; Vera Heuer5; Bülent Sargin6;

Stephan Hollerbach7; Christof Lamberti8; Andrea Tannapfel2;

AnkeReinacher-Schick1

1Department of Hematology, Oncology and Palliative Care, St. Josef-Hospital

Bochum, Ruhr-University Bochum, Bochum, Deutschland

2Institute of Pathology, Georgius Agricola Stiftung Ruhr, Ruhr-University

Bochum, Bochum, Deutschland

3Department of Medical Informatics, Biometry and Epidemiology, Ruhr-

University Bochum, Bochum, Deutschland

4Department of Visceral and General Surgery, St. Josef-Hospital Dortmund,

Dortmund, Deutschland

5Department of Oncology, St. Anna Hospital Herne, Herne, Deutschland

6Hematology and Internal Oncology, St. Marien Hospital Lünen, Lünen,

Deutschland

7Department of Medicine and Gastroenterology, Allgemeines Krankenhaus

Celle, Celle, Deutschland

8Hematology and Oncology, Klinikum Coburg, Coburg, Deutschland

Background: e incidence of EO-CC (age <50 years (yrs)) is rising with

limited data on its clinical and molecular characteristics. We analyzed a

real world cohort of the AIO CPP Registry.

Methods: CPP collects data and tissue from patients (pts) with CC UICC

stage I-III. Clinical and molecular characteristics were assessed compar-

ing pts <50yrs with pts 50+ using student’s t Test and Fishers exact test.

Disease-free (DFS) and overall survival (OS) rate at 3 and 5 yrs were

reported. Median follow-up was 28.1 months.

Results: Out of 9399 pts 479 (5%) had EO-CC (median age 44 yrs (22-49)

vs. 72 yrs (50-100) in late-onset (LO-)CC. ere were no signicant dier-

ences regarding sex or BMI. Younger pts had less comorbidities (Charlson

comorbidity Index, CCI 0: 91%) than older pts. (CCI 0: 60%, p <0.001).

Interestingly, younger patients had larger tumors (p=0.045), more oen

lymph node metastases (p=0.002) and thus higher UICC stages (p<0,001).

Tumor localization was predominantly le-sided in EO- (53%) and right-

sided in LO-CC (61%, p<0,001). Younger pts more oen received adjuvant

chemotherapy and oxaliplatin combinations (p<0,001). Mutational anal-

ysis was available in 5048 pts. No signicant dierence in K- or N-RAS

mutations or MSI were detected. e KRAS subtype p.G12C and BRAF

mutations were signicantly less prevalent in EO- compared to LO-CC

(p=0,03 and p<0,01). Younger pts had a better 3 yrs DFS and 5yrs OS rate.

Discussion: Pts with EO-CC in our unique real world cohort have more

oen le primary tumors with more advanced stages, and yet better DFS/

OS. is may be due to fewer comorbidities and more intense chemother-

apy regmiens, but also distinct mechanisms of tumor biology may play a

role. Notably, existing prognostic data until now have yielded conicting

results. EO-CC pts display distinct molecular features which should be

considered when making treatment decisions.

Conclusion: Further research is imperative to gain a deeper understand-

ing of the distinctive characteristics within this demographic. Real-world

data can play a crucial role in addressing this question.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts238

Gastrointestinal Cancer: other than colorectal

1076

Single-cell proling unleashes KRAS-driven redrafting of the

tumor microenvironment before cancer onset

Chantal Allgöwer1; James Nagai2; Meike Hohwieler1; Ivan Costa2;

Alexander Kleger1

1Institute of Molecular Oncology and Stem Cell Biology, University Hospital Ulm,

Ulm, Deutschland

2Institute for Computational Genomics, RWTH Aachen University, Aachen,

Deutschland

Background: Pancreatic cancer is a highly lethal disease, commonly char-

acterized by aggressiveness and a unique microenvironment, with mutant

KRAS signaling being a pathophysiological hallmark event.

Methods: In order to gain a better understanding of KRAS-dependent sig-

naling, stem cell-derived pancreatic ductal-like organoids (PDLOs) were

induced by oncogenic KRAS expression followed by single cell RNA- and

bulk ATAC-sequencing. Furthermore, in silico approaches were used to

reconstruct a virtual pancreatic cancer space to unleash the KRAS driven

pathways mediating CAF reprogramming and T cell shielding preceding

cancer onset.

Result: is unique precancer state model allowed a comprehensive char-

acterization of early oncogenic events at cellular resolution. Specically,

mutated KRAS separated two ductal subpopulations with distinct gene

expression signatures, including overexpression of genes related to cell

motility and migration as well as enhanced cytokine-related signaling.

Various co-culture systems showed that KRASG12D-expressing PDLOs

are capable of inducing cancer-associated broblast (CAF) dierentiation

while also shielding KRAS-activated yet non-cancerous organoids from

Tcell inltration in vitro.

Disclosure Statement: e authors declare no conict of interest.

1123

Proton Therapy for Unresectable and Medically Inoperable

Locally Advanced Pancreatic Cancer

Ahmed Gawish1; Fabian Eberle1; Hilke Vorwerk1; Sebastian Adeberg1

1Universitätsklinikum Gießen und Marburg, Marburg, Deutschland

Background: is research investigates the side eects, survival rates,

and disease control outcomes of LAPC patients treated with PBT in our

facility.

Methods: A cohort of 44 patients diagnosed with inoperable LAPC at our

center were treated using PBT with a curative approach. A majority of the

patients underwent either prior or simultaneous chemotherapy. Kaplan-

Meier analysis measured overall survival, locoregional recurrence-free

survival, time to locoregional recurrence, distant metastasis-free survival,

and time to subsequent progression or metastasis.

Result: e median radiation dose administered was 54 Gy over 30 ses-

sions (range: 50.4-59.4 Gy over 19-33 sessions). e side eects were

manageable. Four severe (grade III and IV) adverse events (bone mar-

row dysfunction, gastrointestinal disturbances, stent displacement,

heart attack) were noted during or immediately post-radiotherapy; two

were attributed to the combination of chemo and radiation therapy.e

median overall survival post-diagnosis was 15 months (ranging from

3-41 months), while post-PBT it was 8 months (3-33 months). Median

locoregional recurrence-free survival post-PBT stood at 7.3 months

(2-27 months), with distant metastasis-free survival at 5.6 months (4-28

months). e rates for remaining free from locoregional recurrence at 6,

12, and 24 months were 86%, 70%, and 60%, respectively. All patients n-

ished the treatment without interruptions.

Discussion: ese results align with the recognized benets of proton

therapy. However, the ndings’ generalizability is restricted due to the

limited number of participants.

Conclusion: For LAPC, PBT showcased high tolerability and achieved

disease control and survival outcomes comparable to intensied pho-

ton-based radiation therapy.

Disclosure Statement: e authors declare no conict of interest.

1138

A comprehensive multiomics approach unravels druggable

tumor–stroma interactions in ATM-decient pancreatic cancer

Elodie Roger1; Eleni Zimmer1; Dharini Srinivasan1; Anna Härle1;

ArielAsuzano1; Michael Melzer1; Hannah Mummey2; Yun Lee2;

KyleJ.Gaulton2; Lukas Perkhofer1; Johann Gout1; Alexander Kleger1

1Institute for Molecular Oncology and Stem Cell Biology, Ulm University

Hospital, Ulm, Deutschland

2Department of Pediatrics, UC San Diego, La Jolla, USA

Background: e complex biology of pancreatic ductal adenocarcinoma

(PDAC) remains a signicant challenge and limits overcoming its dismal

prognosis. Dynamic interactions within the tumor microenvironment

(TME) play a crucial role in PDAC pathogenesis. Uncharted eld lies in

the impact of gene mutations within the tumor epithelium on driving dis-

tinct oncogenic TME patterns. Our investigation into homologous recom-

bination deciency (HRD) caused by ATM inactivation, revealed its role

in promoting PDAC aggressiveness and desmoplastic reaction, suggesting

a unique TME programing.

Methods: Single-nucleus multiomics on ATM and/or P53-depleted

mouse PDACs, transcriptomics, secretomics, proteomics, and validation

in human cases, unveiled epigenetic, transcriptional, translational, and

secretory regulatory events, shedding light on the intricate dialog between

tumor cells and TME.

Results/Discussion: Multiomics integrative analysis and histological val-

idation in human PDACs showed ATM loss-specic myCAF enrichment

and reduced neutrophil and macrophage contents. Cell–cell communica-

tion inference revealed an ATM loss-specic tumor–CAF dialog driven

by TGFb signaling but distinct communication patterns between CAFs

and immune cells. Mechanistically, we validated a greater TGFβ release

by ATM-decient cells and revealed a reactive oxygen species (ROS)-

mediated phenomenon impacting tumor cell behavior and interplay

with CAFs. Combinatorial therapy targeting the TGFb-driven tumor–

stroma dialog reversed cancer-promoting TME remodeling and boosted

FOLFIRINOX cytotoxicity in vivo, exclusively in ATM-decient PDACs.

Conclusions: Our study unveils the role of ATM-decient HRD tumor

cells in orchestrating oncogenic communication networks with CAFs

and immune cells. Our ndings paint a comprehensive picture of how

distinct tumor–stroma interactions reshape the TME, steering it towards

a cancer-promoting outcome and shed light on the potential to exploit

genotype-specic vulnerabilities via tailored tumor–stroma interference

strategies.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 239

Genitourinary Cancer including Prostate

Cancer

986

Metastases-directed therapy delays PSA-progression in oligo-

progressive castration resistant prostate cancer - early results

of a randomized clinical trial

Tobias Hölscher1,2; Fabian Lohaus1,2; Steen Löck1,2; Angelika Borkowetz3;

Christian Thomas3; Jörg Kotzerke4; Mechthild Krause1,2;

EstherG.C.Troost1,2

1Department of Radiotherapy and Radiation Oncology, Faculty of Medicine and

University Hospital Carl Gustav Carus, Dresden, Deutschland

2OncoRay – National Center for Radiation Research in Oncology -, Faculty of

Medicine and University Hospital Carl Gustav Carus, Technische Universität

Dresden, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Deutschland

3Department of Urology, Faculty of Medicine and University Hospital Carl

Gustav Carus, Dresden, Deutschland

4Department of Nuclear Medicine, Faculty of Medicine and University Hospital

Carl Gustav Carus, Dresden, Deutschland

Purpose: e value of metastases-directed therapy (MDT) on outcome in

oligometastatic castration resistant prostate cancer (omCRPC) is unclear.

e randomized OLI-CR-P trial (NCT04141709) assesses MDT without

change of androgen deprivation therapy (ADT) in PSMA-PET-CT staged

patients (pts). We report on a planned interim analysis aer inclusion of

the rst 30 pts.

Methods: Between 12-2019 and 07-2023, pts with rising PSA and castrate

levels of testosterone during ADT or ADT + new androgen receptor path-

way inhibitor (ARPI) aer curative primary therapy and up to 5 PSMA-

positive bone- or lymph node metastases were eligible and randomized

2:1 in MDT and continuation of ADT (Arm 1) or continuation of ADT

alone (Arm 2). MDT was given as local ablative radiotherapy (3 x 10 Gy

or 25 x 2 Gy), at physicians’ discretion. e primary endpoint is the pro-

portion of pts without PSA progression (dened as nadir +2 ng/ml) aer

1 year. e OLI-CR-P study will enroll 66 patients and evaluate if MDT

results in less PSA progression compared to no MDT. At this interim anal-

ysis, the study would be stopped with a negative result if the dierence in

the primary endpoint between the two arms was less than 10%, and with

a positive result if the dierence between the two arms was highly statis-

tically signicant (p<0.001). e Ethics Committee of the TU Dresden

approved the protocol.

Results: 18 pts were allocated to Arm 1, 12 to Arm 2. e median pt age

was 71 years. Pts had undergone primary treatment at median 59 months

(mo) ago and were on ADT for at median 34 mo, and 8 used ARPI. All

but 1 in Arm1 (n=18) had MDT. Lymph node or bone metastases were

present in 11 and 14 pts, respectively, and 5 pts had both. Aer a median

follow-up of 21.3 mo, the median time to PSA-progression was 21.1 in

Arm 1 vs 6.5 mo in Arm 2 (p=0.05).

Discussion: In the pre-planned interim analysis, the addition of MDT

extended the time to PSA progression. However, as the pre-specied stop-

ping criteria for the OLI-CR-P interim analysis were not met, enrollment

will continue.

Conclusions: MDT in omCRPC seems promising, even without modi-

cation of systemic treatment.

Disclosure Statement: e authors declare no conict of interest.

1124

Nectin-4 and Trop-2: new therapeutic targets in penile cancer?

Jan Mink1; Markus Eckstein2; Oybek Khalmurzaev3; Alexey Pryalukhin4;

Carol Geppert2; Stefan Lohse5; Kristof Bende2; João Lobo6; Rui Henrique6;

Hagen Loertzer7; Joachim Steens8; Carmen Jerónimo6;

HeikoWunderlich9; Julia Heinzelbecker1; Rainer Bohle4; Michael Stöckle1;

Vsevolod Matveev3; Arndt Hartmann2; Kerstin Junker1

1Universitätsklinikum des Saarlandes, Abteilung für Urologie und

Kinderurologie, Homburg, Deutschland

2Universitätsklinikum Erlangen-Nürnberg, Institut für Pathologie, Erlangen,

Deutschland

3N.N. Blokhin National Medical Research Center of Oncology des

Gesundheitsministeriums der Russischen Föderation, Abteilung für Urologie,

Moskau, Russische Föderation

4Universitätsklinikum des Saarlandes, Abteilung für Pathologie, Homburg,

Deutschland

5Universitätsklinikum des Saarlandes, Abteilung für Virologie, Homburg,

Deutschland

6Portuguese Oncology Institute of Porto / Porto Comprehensive Cancer Center

Raquel Seruca, Department of Pathology and Cancer Biology and Epigenetics

Group – Research Center & School of Medicine and Biomedical Sciences

(ICBAS), University of Porto, Porto, Portugal

7Westpfalz-Klinikum, Abteilung für Urologie und Kinderurologie, Kaiserslautern,

Deutschland

8St.-Antonius-Hospital, Abteilung für Urologie und Kinderurologie, Eschweiler,

Deutschland

9St. Georg Klinikum, Abteilung für Urologie und Kinderurologie, Eisenach,

Deutschland

Background: While eective systemic therapies for penile cancer (PC) are

still missing, antibody-drug conjugates (ADC) as sacituzumab govitecan

(SG) and enfortumab vedotin (EV), ADCs against Trop-2 and Nectin-4,

showed high response rates in various tumor entities. erefore we inves-

tigated the expression of Trop-2 and Nectin-4 in PC as possible therapeu-

tic targets.

Methods: Clinical data and tissue samples from 203 patients with PC

from Germany, Russia and Portugal were collected. TNM, histological

subtype, grading and HPV-status were evaluated. Tissue micro arrays

from the primary tumor and lymph node metastases were constructed.

Nectin-4 and Trop-2 expression were analyzed using immunohistochem-

istry and classied by H-score (0-14 = negative; 15-99 = weak; 100-300 =

moderate/high).

Result: Moderate or high membranous Nectin-4 expression was found

in in 28.0% of the primary tumor samples and in 18.8% of metastases.

Expression in the primary tumor decreased signicantly with increasing

T-stage (p = <0.001) and did not correlate with HPV status (p = 0.788). It

was also not associated with metastasis-free (p = 0.758), cancer-specic (p

= 0.261) or overall survival (p = 0.345). Median H-score of Trop-2 was 270

and 300 in the primary tumor and metastases, respectively. 97.8% of pri-

mary tumors and 97.6% of metastases showed moderate or high Trop-2

expression.

Discussion: Nectin-4 expression in PC is less common compared to

other squamous cell carcinomas. Particularly advanced, more aggressive

tumors showed lower expression. In contrast, Trop-2 is more commonly

expressed in PC.

Conclusion: EV therapy may be useful for selected patients with Nectin-4

positive tumors. As Trop-2 is highly expressed in almost all PCs, it seems

a very interesting target for an ADC therapy with SG that has to be inves-

tigated in clinical trials. In parallel, preclinical studies are necessary to

evaluate the rationale and biological eects of these new promising ther-

apeutic options.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts240

1026

Big data analytics with routine claims data according to §21

KHEntgG for method comparison in transurethral urothelial

carcinoma resection with and without photodynamic

diagnostics provides meaningful insights with real world data

Gerson Lüdecke1; Eva Bernauer2; Manuel Heurich2; Rita Lüdecke3

1UKGM Gießen GmbH, Klinik und Poliklinik für Urologie, Kinderurologie und

Andrologie, Gießen, Deutschland

2BinDoc GmbH, Tübingen, Deutschland

3mSE medizinische Software Entwicklung, Linden, Deutschland

Background:e hypothesis that photodynamic diagnostics (PDD) pro-

vides better results than white light (WL) resection in non-muscle-inva-

sive bladder cancer (NMIBC) will be tested using a representative sample

of German anonymizedroutine claims data according to §21 KHEntG.

e superiority of PDD is characterized by a higher indication for post-

resection as an indicator for high risk classication in NMIBC, a higher

percentage of D09.0, more 2-year recurrence free survival, fewer recur-

rence resections, longer interval until recurrence, and less cystectomy.

Methods:From the BinDoc research database, we take all patients with

OPS-Code 5-573.40 or 5-573.41 and main diagnosis C67.n or D09.0

between 2019 and 2022. We make sure that a patient hasn’t been treated

up to 15 months before inclusion and that we can follow a patient for two

years from admission based on the patient’s hashed insurance ID. is

provides us with a sample of 1751 cases (PDD: 432, WL: 1319) from 38

clinics from 01/04/2020 until 31/12/2020. We compare percentages and

mean values of the quantities of interest from the PDD and the WL group,

with p-values calculated aer Pearson’s chi-squared, Fisher’s exact test or

the Wilcoxon rank sum test.

Results:We nd that 35.19% of PDD and 25.25% of WL cases (p=0.0001)

get a post-resection; both groups were equal in the amount of D09.0

diagnosis (p=0.62) and risk of recurrence (34.03% and 30.17%; p=0.15);

whereas the mean time to recurrence (234 days for PDD versus 202 days

for WL (p=0.048)) is prolonged; and cystectomy rate is less likely among

PDD cases (9.72% to 14.40%; p=0.016).

Discussion:e results provide strong evidence that PDD is superior to

WL resection in NMIBC in terms of a stronger indication for post-resec-

tion, a longer time to recurrence, and a lower risk of cystectomy.

Conclusions: e analyses were conducted with billing data instead

of classical cancer registry data, and they were based on a sub-sam-

ple of German clinics and required a follow-up of each patient for two

years.Given these challenges, it is remarkable that we could show a supe-

riority of PDD compared to WL.

Disclosure Statement: e authors declare no conict of interest.

Gynecologic Cancer

1049

Cost-Eectiveness Studies Evaluating HPV Self-Sampling for

Cervical Cancer Screening – a Systematic Review

Lara Hallsson1; Marc Riedlsperger1; Anna-Maria Hoacher1;

LéonieHéloïseHaaf1,2,3; Milena Mühler1; Peter Hillemanns4;

MatthiasJentschke4; Uwe Siebert1,5,6; Gaby Sroczynski1

1Department of Public Health, Health Services Research, and Health Technology

Assessment, UMIT TIROL – University for Health Sciences and Technology, Hall

i.T., Österreich

2Institute for Medical Information Processing, Biometry and Epidemiology - IBE,

LMU Munich, Munich, Deutschland

3Pettenkofer School of Public Health, Munich, Deutschland

4Department of Gynaecology and Obstetrics, Hannover Medical School,

Hannover, Deutschland

5Center for Health Decision Science, Departments of Epidemiology and Health

Policy & Management, Harvard T. H. Chan School of Public Health, Boston, USA

6Institute for Technology Assessment and Department of Radiology,

Massachusetts General Hospital, Harvard Medical School, Boston, USA

To systematically evaluate studies investigating the cost eectiveness of a

possible implementation of human papillomavirus (HPV) self-sampling

(HPV-SS) for cervical cancer screening. Relevant databases (including

Medline (PubMed)) were searched (until 11/2023) for studies investigat-

ing the cost eectiveness of HPV-SS in cervical cancer screening in mid-

dle- and high-income countries in Europe. e PRISMA guidelines were

followed. Cohort studies, randomized controlled trials and decision-an-

alytic modeling studies published in English or German were included.

Key study characteristics (including author/year/country/currency/target

population/study type) and outcomes (e.g., incremental cost-eectiveness

ratios [ICER]) were extracted and reported into a standardized evidence

table. e study quality was assessed using the CHEERS checklist. e

original currency was converted to Euro (index year 2022) for cross-coun-

try comparison. Of 2,431 studies, eleven studies met the inclusion crite-

ria. ese included six model-based cost-eectiveness evaluations and

ve economic evaluations along trials and were primarily conducted in

high-income countries. All studies compared HPV-SS with standard care

(e.g., Pap smear/conventional cytology, clinician-collected HPV testing,

standard reminder letters to get screened). Only few studies investi-

gated HPV-SS in all screening-eligible women, most studies investigated

HPV-SS in women not attending regular screening. Direct home mailing

of the HPV-SS kit was the preferred method to reach women. ICERs were

reported in nine studies and ranged from 2,900 EURO per quality-ad-

justed life year (QALY) gained for the provision of HPV-SS-based screen-

ing for non-participants (Netherlands) to 90,200 EURO/QALY (Sweden)

for a combined strategy (cytology screening up to the age 35 years +

HPV test with HPV-SS from age 35 years). All studies showed HPV-SS

to increase screening participation. Screening with HPV-SS can be a cost-

eective, practical, and feasible approach to increase screening coverage.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 241

Head and Neck Cancer

1064

Exosomal miRNA as possible liquid biomarker for HPV+ Head

and Neck Squamous Cell Carcinoma

Maximilian Oberste1; Carla Apeltrath1; Armands Riders1; Frank Simon1;

Claudia Rudack1

1Universitätsklinikum Münster/Klinik für Hals-, Nasen- und Ohrenheilkunde,

Kopf- und Halschirurgie, Münster, Deutschland

Background: Head and neck squamous cell carcinomas (HNSCC) tend

to develop early lymphogenic metastasis, but reliable laboratory markers

are lacking.e determination of exosomal miRNA (miR) as part of a liq-

uid biopsy could be a new promising marker for prognosis and treatment

choice of HPV+ HNSCC.

Methods: In the period from June 2021 to August 2022, 66 patients (50

HNSCC/16 cancer free) were acquired at the ENT clinic at University hos-

pital Münster. Ablood sample was taken from the tumor population as

part of the panendoscopy and 12 months aer the initial diagnosis.e

exosomal miRNA load for miR-21, miR-1246, miR-let7a, miR-181a, and

miR-26a was determined using rt-PCR. e expression ratios of the six

miRNAs in reference to the tumor-free normal population were exam-

ined using mixed linear models for relationships with clinical parameters

(UICC, smoking and alcohol behavior, HPV status) and type of therapy.

Result: Exosomal miR-21 and miR-let7a were on average three times

higher expressed in HPV/p16+ HNSCC at initial diagnosis than in HPV/

p16- HNSCC (p<0.001; p=0.003). In comparison, exosomal miR-181a

was increased by an average of 2.4-fold (p=0.008). Aer 12 months, HPV/

p16+ HNSCC showed half the reduced expression of exosomal miR-

21 than in HPV/p16- patients (p=0.028). 22 patients (11 HPV+ and 11

HPV-) suered of an oropharyngeal carcinoma. In this subgroup the exo-

somal expression of miR-let-7a was on average more than threefold higher

(p=0.039) and that of miR-26a was more than vefold higher (p=0.041) in

patients without lymph node involvement (n=11) than in patients with N1

oder N2 stages (n=11).

Discussion: Exosomal miR-21, miR-let7a and miR-181a are signicantly

upregulated in HPV+ HNSCC compared to HPV- HNSCC at initial diag-

nosis. Furthermore, exosomal miR-let7a and miR-26a were signicantly

dierent in the oropharyngeal subgroup in relation to lymph node status

at initial diagnosis.

Conclusion: In our study, specic exosomal miRNAs are shown to be

potential liquid biomarkers for HPV+ HNSCC.

Disclosure Statement: e authors declare no conict of interest.

977

Blocking of Eag1 in OSCC

Susanne Wolfer1; Philipp Kaumann1; Henning Schliephake1; Luis Pardo2

1Universitätsmedizin Göttingen, Göttingen, Deutschland

2Max Planck Institut für Multidisziplinäre Naturwissenschaften, Göttingen,

Deutschland

Background: Eag1 (Kv10.1) is the rst voltage-dependent potassium

channel to be linked to tumorigenesis and detected in a variety of human

malignancies 1. In previous studies, we were able to document Eag1 in

OSCC for the rst time 2. Astemizole and imipramine are inhibitors of

Eag1, but they also block similar cardiac channels (Erg’s) 3. A targeted

induction of apoptosis of Eag1+ cancer cell lines using TRAIL-constructs

was described 4. In this study, we investigated the impact of blocking Eag1

on OSCC cell lines.

Methods: Induction of apoptosis by astemizole (5µM), imipramine

(25µM) and Eag1 Antibody-TRAIL fusions (scFv62-scTRAIL or VHH-

D9-scTRAIL, 150 pM) was determined in the cell lines HN and SCC-081.

Apoptosis was monitored using caspase-3/7 activity in a live cell imaging

Incucyte system. Functional expression of Eag1 and the eect of blocking

were tested using patch clamp in cells in culture.

Result: Aer the addition of imipramine and astemizole, an increased

apoptosis rate could be detected (astemizole: HN p < 0.001, SCC081 p <

0.0001; imipramine: HN p < 0.0001, SCC081 p < 0.0001). e functional

expression of Eag1 and its blocking by astemizole and imipramine were

conrmed using pach clamp in HN cells. To date, no targeted induction

of apoptosis could be demonstrated with the TRAIL-constructs in OSCC.

Discussion: e blocking of Eag1 has been described in some ways 3.

Aer the initial detection of Eag1, we were now also able to demonstrate

the function and blocking of this channel in OSCC, which provides an

important basis for further therapy-relevant research.

Conclusion: Inhibition of Eag1 (Kv10.1) is possible in OSCC in vitro

using astemizole and imipramine. Further studies to demonstrate a tar-

geted blocking using TRAIL-constructs are still necessary.

References:

1 Pardo, L.A. et al. 1999, EMBO J. 18, 5540-5547

2 Wolfer et al. 2022, Oncol Res Treat 2022;45

3 Toplak et al. 2022 Med Res Rev. Jan; 42(1):183-226

4 Hartung et al. 2020 Front Pharmacol. May 14;11:686

Disclosure Statement: e authors declare no conict of interest.

Health Economy/Public Health

1134

Evaluation of Long-term Benets, Harms and Cost-

Eectiveness of Including HPV Self-Sampling Oered to

Non-Attendees of the Organized Cervical Cancer Screening

Program in Germany

Gaby Sroczynski1; Lara Hallsson1; Milena Mühler1; Peter Hillemanns2;

Matthias Jentschke2; Uwe Siebert1,3,4

1Department of Public Health, Health Services Research, and Health Technology

Assessment, UMIT TIROL – University for Health Sciences and Technology, Hall

in Tirol, Österreich

2Department of Gynaecology and Obstetrics, Hannover Medical School,

Hannover, Deutschland

3Center for Health Decision Science, Departments of Epidemiology and Health

Policy & Management, Harvard T. H. Chan School of Public Health, Boston, USA

4Institute for Technology Assessment and Department of Radiology,

Massachusetts General Hospital, Harvard Medical School, Boston, USA

Background: We systematically evaluated benets, risks, and cost-ef-

fectiveness of dierent cervical cancer screening strategies oering

additionally Human papillomavirus (HPV) self-sampling (HPV-SS) to

non-attendees.

Methods: A validated Markov model for the German context was used to

evaluate additional HPV-SS for non-attendees age 25-65, 30-65 or 35-65

years, every ve years with regular invitation, either Opt-in (invitation with

link to order test), or Send-to-all (test sent with invitation) compared to stan-

dard CC screening alone. German clinical, epidemiological, economic data

(indexed 2022/23), along with test accuracy and HPV-SS-attendance data

from international meta-analyses and trials were incorporated. Outcomes

included undiscounted life-years gained (LYG), and positive test results (PT)

per 1000 women compared to standard screening without HPV-SS, and the

incremental cost-eectiveness ratio (ICER; in EUR/LYG). Comprehensive

sensitivity analyses were conducted to check the robustness of ndings.

Result: Incremental undiscounted LYG (PT) per 1000 women (each

compared to standard screening without HPV-SS) ranged between 0.90

LYG (28 PT) for oering with ve-yearly screening invitation an HPV-SS

(Opt-in) to non-attendees age 35-65 and 1.67 (62 PT) for HPV-SS (send-

to-all) age 30-65 or age 25-65 years. Corresponding discounted ICERs

(compared to next eective) for non-dominated HPV-SS screening strat-

egies were 22,700 EUR/LYG for HPV-SS (Opt-in) age 35-65, 25,900 EUR/

LYG for HPV-SS (send-to-all) age 35-65, 726,000 EUR/LYG for HPV-SS

(send-to-all) age 30-65, and 1.78 mio. EUR/LYG for HPV-SS (send-to-

all) age 25-65 years. Other Opt-in strategies were dominated. Results were

robust over a wide range of parameter variations.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts242

Discussion/Conclusion: Oering HPV-SS (Send-to-all) to non-attendees

every ve years as of age 35 as an additional strategy within the organ-

ised CC screening program is eective and cost- eective. Findings can

be used to inform decision-makers and clinical guideline developers in

Germany.

Disclosure Statement: e authors declare the following: is work was carried

out as part of the HaSCo study (Hanover Self-Collection Study for the Prevention

of Cervical Cancer) which was funded by a grant of the Deutsche Krebshilfe.

1137

Working-age cancer: association between sociodemographic,

clinical and patient-related characteristics and the risk of

earning incapacity

Sarah Schröer1; Melanie Kolb1; Kerstin Garbrock1; Vera Ries1;

Klaus-PeterThiele1

1Medizinischer Dienst Nordrhein, Düsseldorf, Deutschland

Background: A third of cancer cases in Germany aect people of working

age. Health impairments due to the disease or therapy may risk occupa-

tional participation. e study investigates 1. which tumor sites predomi-

nantly lead to an assessment of earning capacity by the Medical Service, 2.

how oen a reduction in earning capacity is conrmed, and what associa-

tions exist with patient characteristics.

Methods: e study is based on routine data from expertise carried out by

the North Rhine Medical Service for statutory health insurance between

01.01.22 and 19.11.23 on men and women diagnosed with cancer (C00-97

w/o C44) of working age (20-64 years). e primary outcome was con-

rmed reduction of earning capacity; associations with age, gender, occu-

pation, fatigue, tumor stage, need for care and mental comorbidity were

tested by Pearson’s chi squared test.

Results: During the observation period 2525 people (58% women) were

assessed. Most frequently assessed tumor sites in women are breast (37%),

lung (11%), secondary tumors (9%), in men lung (14%), secondary

tumors (13%), colon (12%). Compared to proportionate frequencies of

cancer incidence, brain tumors (+129% women, +127% men) and multi-

ple myeloma (+97% women, +107% men) are examined more frequently.

Malignant melanomas (women -78%, men -74%), thyroid cancer (women

-88%, men -68%) and, in men, carcinomas of prostate (-61%) and testicles

(-75%) were assessed less frequently. Reduced earning capacity was more

common in lung (39%) and pancreatic cancer (40%) than in breast can-

cer (18%). For most cancers, reduced earning capacity was signicantly

associated with tumor stage and need of care. Fatigue, polyneuropathy

and mental comorbidity showed signicant association in some cancers.

Discussion & Conclusion: e proportion of cancer patients aected by

reduced earning capacity varies between tumor sites, but also with patient

characteristics. Addressing this challenge is of great relevance for service

providers, employers and health politics, not least in view of demographic

developments and the shortage of skilled workers.

Disclosure Statement: e authors declare no conict of interest.

Hematooncology including Bone marrow

transplantation, Lymphoma, Plasmocytoma

966

Secondary immunodeciencies and susceptibility to

infections in patients with non-Hodgkin’s lymphomas during

anti-CD20-antibody containing treatments

Stefan Feiten1; Ursula Vehling-Kaiser2; Johannes Mohm3;

MichaelGärtner4; Jörg Lipke5; Karl Verpoort6; Achim Rothe7; Rudolf Weide8

1Institut für Versorgungsforschung in der Onkologie, Koblenz, Deutschland

2ÜBAG MVZ Dr. Vehling-Kaiser GmbH, Landshut, Deutschland

3Gemeinschaftspraxis Dres. Mohm, Prange-Krex, Dresden, Deutschland

4Onkologisches Ambulanzzentrum (OAZ), Hannover, Deutschland

5Gemeinschaftspraxis für Hämatologie und Onkologie, Dortmund, Deutschland

6Schwerpunkt Hämatologie, Onkologie und Palliativmedizin, Hamburg,

Deutschland

7MVZ West GmbH, Köln, Deutschland

8Praxis für Hämatologie und Onkologie, Koblenz, Deutschland

Background: Only limited real-world data exist about immune status and

susceptibility to infections in correlation to anti-CD20-antibody contain-

ing therapies in non-Hodgkin’s lymphoma (NHL) patients.

Methods: Multicenter prospective analysis of 52 NHL patients who

started anti-CD20-antibody containing treatments between 04/21 and

11/22. With the help of patient diaries infections over the course of one

year were captured. Additionally, diagnosis and treatment data were

extracted from medical records retrospectively. Data was statistically ana-

lyzed using SPSS 29.

Result: So far 52 patients with a median age of 68.5 (32-90) could be

analyzed. 54% were male, 46% female. 27% suered from follicular lym-

phoma, 25% from CLL and 58% from other NHL. During the observa-

tion period 4 patients (8%) died, 2 of them from an infection. e most

frequently used protocols were R-CHO(E)P (31%), BR (27%) and ritux-

imab mono (13%). A quantitative determination of T helper cells (CD4

lymphocytes) was carried out in only 11 patients (21%). A comparison

of the mean values across all measurements before and aer the start of

treatment showed a clear dierence (1,217/µl vs. 478/µl) (p=.052). In 17

patients (33%) a quantitative determination of the IgG trough level was

carried out. Mean values across all measurements before (831mg/dl) and

aer the start of therapy (701mg/dl) were not statistically signicantly dif-

ferent (p=.124). Standardized to 1,000 days, the mean number of infec-

tions before treatment was 2.57 compared to 6.86 across all measurements

aer the start of therapy (p<.001).

Discussion: Infectious complications are increased during anti-CD20-an-

tibody therapies in routine care. Immune monitoring is only performed in

a minority of patients.

Conclusion: We suggest that immune monitoring with measurement of

serum IgG-levels, IgG-subclasses and T helper cell counts should be part

of routine laboratory analysis during NHL therapy to enable prophylactic

and timely actions preventing serious infectious complications.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 243

1051

Ecacy and safety of luspatercept versus epoetin alfa (EA) in

erythropoiesis-stimulating agent (ESA)-naive patients (pts)

with transfusion-dependent (TD) lower-risk myelodysplastic

syndromes (LR-MDS): full analysis of the COMMANDS trial

Uwe Platzbecker1; Guillermo Garcia-Manero2; Valeria Santini3;

Amer M. Zeidan4; Pierre Fenaux5; Rami S. Komrokji6; Jake Shortt7;

DavidValcárcel8; Anna Jonášová9; Sophie Dimicoli-Salazar10;

Ing Soo Tiong11; Chien-Chin Lin12; Jiahui LI13; Jennie Zhang13;

Ana Carolina Giuseppi13; Sandra Kreitz14; Veronika Pozharskaya13;

Karen L. Keeperman13; Shelonitda Rose13; Thomas Prebet13;

Andrius Degulys15,16; Stefania Paolini17; Thomas Cluzeau18;

Matteo Giovanni Porta19,20

1Medical Clinic and Policlinic 1, Hematology and Cellular Therapy, University

Hospital Leipzig, Leipzig, Deutschland

2Department of Leukemia, The University of Texas MD Anderson Cancer Center,

Houston, USA

3MDS Unit, DMSC, Azienda Ospedaliero-Universitaria Careggi, University of

Florence, Florence, Italien

4Department of Internal Medicine, Yale School of Medicine and Yale Cancer

Center, Yale University, New Haven, USA

5Service d’Hématologie Séniors, Hôpital Saint-Louis, Université Paris, Paris,

Frankreich

6Mott Cancer Center, Tampa, USA

7Monash University and Monash Health, Melbourne, Australien

8Hospital Universitari Vall d’Hebron, Barcelona, Spanien

9Medical Department Hematology, Charles University General University

Hospital, Prague, Tschechische Republik

10Hôpital Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux,

Bordeaux, Frankreich

11Malignant Haematology & Stem Cell Transplantation, The Alfred, Melbourne,

Australien

12Department of Laboratory Medicine, National Taiwan University Hospital,

Taipei, Taiwan

13Bristol Myers Squibb, Princeton, USA

14Celgene International Sàrl, a Bristol-Myers Squibb Company, Boudry, Schweiz

15Hematology, Oncology and Transfusion Medicine Center, Vilnius University

Hospital Santaros Klinikos, Vilnius, Lithuania

16Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius,

Lithuania

17IRCCS Azienda Ospedaliero-Universitaria di Bologna - Istituto di Ematologia

“Seràgnoli”, Bologna, Italien

18Département d’Hématologie Clinique, Université Cote d’Azur, CHU Nice, Nice,

Frankreich

19Cancer Center IRCCS Humanitas Research Hospital, Milan, Italien

20Department of Biomedical Sciences, Humanitas University, Milan, Italien

Background: ESAs are an established treatment (tx) for pts with TD

LR-MDS, yet outcomes are poor. In the preplanned interim analysis of the

phase 3 COMMANDS trial (NCT03682536) comparing luspatercept with

EA for the tx of anemia in ESA-naive TD pts with LR-MDS, luspatercept

showed superiority over EA in improving red blood cell transfusion inde-

pendence (RBC-TI) rates (Platzbecker U, et al. Lancet 2023;402:373-385).

Here, we report the full ecacy and safety analysis of the COMMANDS trial.

Methods: Eligible pts were aged ≥ 18 years, had Revised International

Prognostic Scoring System-dened LR-MDS, serum erythropoietin < 500

U/L, were TD (received 2–6 RBC U/8 weeks [wk] for ≥ 8 wk before ran-

domization) and ESA-naive. Pts, randomized 1:1, received luspatercept

(1.0–1.75 mg/kg) subcutaneously (SC) Q3W, or EA (450–1050 IU/kg) SC

Q1W for ≥ 24 wk. Primary endpoint was RBC-TI ≥ 12 wk with a concur-

rent mean hemoglobin (Hb) increase of ≥ 1.5 g/dL (wk 1–24).

Result: As of Mar 31, 2023, 182 pts were randomized to luspatercept and

181 to EA; median tx duration (range) was 51.3 (3–196) and 37.0 (1–202)

wk and median follow-up (range) was 17.2 (1–46) and 16.9 (0–46) months,

respectively. In the luspatercept arm, 110 (60.4%) pts achieved the pri-

mary endpoint versus 63 (34.8%) in the EA arm (P < 0.0001). Overall,

178 (97.8%) and 165 (92.2%) pts receiving luspatercept and EA reported

tx emergent adverse events (TEAEs) of any grade; 107 (58.8%) and 88

(49.2%) pts reported grade 3/4 TEAEs, respectively. In both tx arms, rates

of AML progression (2.7% and 3.3%, in the luspatercept arm versus the

EA arm), and rates of on- and post-tx deaths were similar.

Discussion: Superior primary endpoint response rates and RBC-TI

duration were seen with luspatercept versus EA. ese results conrm

the interim analysis ndings; safety results were consistent with previous

MDS studies.

Conclusion: Luspatercept could be a new standard of care for pts with TD

LR-MDS. Abstract presented at ASH 2023. Garcia-Manero G, et al. Blood

(2023). Reused with permission.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

Lung Cancer

1018

ALINA: ecacy and safety of adjuvant alectinib versus

chemotherapy in patients with early-stage ALK+ non-small

cell lung cancer (NSCLC)

Rajiv Shah1; Benjamin J. Solomon2; Jin Seok Ahn3; Rafal Dziadziuszko4;

Fabrice Barlesi5; Makoto Nishio6; Dae Ho Lee7; Jong-Seok Lee8;

WenzhaoZhong9; Hidehito Horinouchi10; Weimin Mao11;

MaximilianHochmair12; Filippo de Marinis13; Maria Rita Migliorino14;

IgorBondarenko15; Tania Ochi Lohmann16; Tingting Xu17;

AndresCardona18; Walter Bordogna19; Thorsten Ruf20; Yi-Long Wu9

1Dept. of Thoracic Oncology, Thoraxklinik, Heidelberg University Hospital and

National Center for Tumor Diseases (NCT), NCT Heidelberg, Translational Lung

Research Center Heidelberg (TLRC-H), Heidelberg, Germany

2Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne

Australia

3Department of Hematology & Oncology, Samsung Medical Center, Seoul,

Republic of Korea

4Department of Oncology & Radiotherapy and Early Phase Clinical Trials Centre,

Medical University of Gdansk, Gdańsk, Poland

5Department of Medical Oncology, International Center for Thoracic Cancers

(CICT), Gustave Roussy,Saclay University, Faculty of Medicine, Kremlin-Bicêtre,

France

6Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake,

Koto, Tokyo, Japan

7Department of Oncology, Asan Medical Center, Seoul, Republic of Korea

8Division of Hematology and Medical Oncology, Department of Internal

Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of

Korea

9Guangdong Lung Cancer Institute, Guangdong Provincial People’s Hospital

(Guangdong Academy of Medical Sciences), Southern Medical University,

Guangzhou, China

10Department of Thoracic Oncology, National Cancer Center Hospital, Chuo City,

Tokyo, Japan

11Institute of Basic Medicine and Cancer, Chinese Academy of Sciences,

Zhejiang, China

12Department of Respiratory & Critical Care Medicine, Klinik Floridsdorf,

Karl-Landsteiner-Institute for Lung Research and Pulmonary Oncology, Vienna,

Austria

13Thoracic Oncology Division, European Institute of Oncology (IRCSS), Milan,

Italy

14Pneumo-Oncology Unit, San Camillo Forlanini Hospital, Roma, Italy

15Oncology and Medical Radiology Department, Dnipropetrovsk Medical

Academy, Dnipro, Ukraine

16PD Oncology, F. Homann-La Roche Ltd, Basel, Switzerland

17Department of Clinical Science, Roche (China) Holding Ltd, Shanghai, China

18Data and Statistical Sciences, F. Homann-La Roche Ltd, Basel, Switzerland

19Product Development Medical Aairs, F. Homann-La Roche Ltd, Basel,

Switzerland

20PD Safety Risk Management, F. Homann-La Roche Ltd, Basel, Switzerland

Background: Current standard of care for patients (pts) with resected,

stage IB–IIIA, ALK+ NSCLC, is adjuvant platinum-based chemotherapy

(CT), which is associated with only modest survival benet. Alectinib is a

preferred rst-line treatment in advanced ALK+ NSCLC. Here, we report

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts244

data from the prespecied interim analysis of ALINA (NCT03456076), a

global, phase III, open-label, randomised trial assessing the ecacy and

safety of adjuvant alectinib compared with CT in pts with completely

resected ALK+ NSCLC.

Methods: Eligible pts were ≥18 years old, had an ECOG PS of 0/1 and

completely resected, stage IB (≥4 cm)–IIIA, ALK+ NSCLC (per UICC 7th

edition). Pts were randomised 1:1 to receive either oral alectinib for 24

months (or until disease recurrence, unacceptable toxicity, or withdrawal

of consent), or up to four cycles of platinum-based CT. Randomisation

was stratied by stage (IB vs II vs IIIA) and race (Asian vs non-Asian).

Primary endpoint: investigator-assessed disease-free survival (DFS),

tested hierarchically rst in the stage II–IIIA and then in the ITT popu-

lation (stage IB–IIIA). Other endpoints included: CNS-DFS, overall sur-

vival (OS), safety.

Result: 257 pts were randomised to receive alectinib (n=130) or CT

(n=127); baseline characteristics were well balanced between arms. At

data cuto (26 June 2023), median follow up was 27.8 months. A signi-

cant DFS benet was observed with alectinib vs CT in both the stage II–

IIIA (HR 0.24; 95% CI: 0.13–0.45) and ITT populations (HR 0.24; 95% CI:

0.13–0.43; table). e DFS benet was maintained across all subgroups.

A clinically meaningful CNS-DFS benet was observed in the ITT pop-

ulation (HR 0.22; 95% CI 0.08–0.58). OS data were immature. No unex-

pected safety ndings were observed.

Discussion: Alectinib signicantly improves DFS compared with CT in

pts with completely resected ALK+ NSCLC and prevents dicult to treat

CNS relapses

Conclusion: Alectinib oers an eective new treatment strategy for pts

with resected ALK+ NSCLC.

Previously presented at ESMO, LBA2, Benjamin J. Solomon et al. - Reused with

permission

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

1126

Outcomes and Side Eects of Image-Guided Single-Dose

Stereotactic Radiotherapy for Lung Tumors

Kerem Tas1; Hilke Vorwerk1; Sebastian Adeberg1; Ahmed Gawish1

1Universitätsklinikum Gießen und Marburg, Marburg, Deutschland

Background: is research sought to present preliminary ndings from

the use of single-dose stereotactic radiotherapy (RT) in treating patients

with inoperable lung tumors.

Methods: At our center, patients received treatment using single-dose

SBRT (25 Gy and 30 Gy, 80% isodose). e study encompassed patients

with inoperable T1-2N0 non-small cell lung cancer (NSCLC) or isolated

lung metastases. e SBRT was administered during a gated breath-hold

with a planning target volume (PTV) margin set between 3-5 mm. Real-

time CBCT scans were evaluated to assess the accuracy and ecacy of the

gated delivery method.

Result: e study involved 95 patients presenting 120 lesions (comprising

61 NSCLC and 59 metastatic tumors). Among the entire cohort, 23 out

of 120 lesions experienced local failure. Local control rates over 12, 24,

and 36 months were 88%, 82%, and 75%, respectively. Within the NSCLC

group, 9 out of 61 lesions showed in-eld failures, with local control rates

at 12, 24, and 36 months being 94%, 85%, and 80%. Meanwhile, for the

group with pulmonary metastases, 14 out of 59 lesions experienced local

failure, and the control rates over 12, 24, and 36 months were 80%, 75%,

and 65%, respectively. Only 6 out of 95 patients exhibited Grade II pneu-

monitis. No patient displayed Grade 3 or 4 toxicities.

Conclusion: Administering single-dose stereotactic RT appears viable for

specic lung tumor patients. A higher dosage correlated with enhanced

local control. Extended observation is essential to fully gauge the treat-

ment’s eectiveness and associated side eects.

Disclosure Statement: e authors declare no conict of interest.

1056

Sacituzumab Govitecan + Pembrolizumab in 1L Metastatic

Non-Small Cell Lung Cancer: Preliminary Results of the

EVOKE-02 Study

Niels Reinmuth1; Byoung Chul Cho2; Manuel Cobo Dols3;

Roxana Reyes Cabanillas4; David Vicente Baz5; Jose Fuentes Pradera6;

Salvatore Grisanti7; Afshin Eli Gabayan8; Ki Hyeong Lee9; Eun Kyung Cho10;

Sabeen Mekan11; Farnoush Safavi11; Nelumka Fernando11;

Michael J. Chisamore12; Martin Reck13

1Asklepios Fachkliniken München-Gauting, Gauting, Deutschland

2Yonsei Cancer Center, Seoul, Republik Korea

3Regional and Virgen de la Victoria University Hospitals, Malaga, Spanien

4Hospital Clinic de Barcelona, Barcelona, Spanien

5Hospital Universitario Virgen Macarena, Seville, Spanien

6Hospital Universitario Virgen de Valme, Seville, Spanien

7Azienda Ospedaliera Spedali Civili di Brescia, Brescia, Italien

8Beverly Hills Cancer Center, Beverly Hills, USA

9Chungbuk National University Hospital, Chungbuk, Republik Korea

10Gachon University Gil Medical Center, Incheon, Republik Korea

11Gilead Sciences, Inc, Foster City, USA

12Merck & Co., Inc., Rahway, USA

13Airway Research Center North, German Center for Lung Research (DZL),

LungenClinic, Grosshansdorf, Deutschland

Background: PD-[L]1 inhibitor–based regimens are the current standard

of care in rst line (1L) mNSCLC and novel combinations are needed.

Sacituzumab govitecan (SG), a Trop-2-directed ADC, demonstrated clin-

ical activity and manageable safety in pretreated patients (pts) with mNS-

CLC. e ongoing, global, open-label, multicohort, Phase 2 EVOKE-02

study (NCT05186974) is evaluating SG + pembrolizumab (pembro) ±

platinum agent as 1L treatment for mNSCLC. Here, we report preliminary

results of pts treated with SG + pembro in Cohorts A and B.

Methods: Adults with previously untreated mNSCLC, no actionable

genomic alterations and an ECOG of 0 or 1 can enroll in Cohorts A or

B. Pts with PD-L1 TPS ≥50% (Cohort A) and <50% (Cohort B) receive

SG 10 mg/kg on day 1 and 8 + pembro 200 mg on day 1 of a 21-day cycle.

Trial endpoints include ORR (per RECIST v1.1), PFS, DoR, DCR, OS and

safety. Safety results are reported in pts who received ≥1 dose of study

treatment and ecacy results are reported in pts with ≥13.0 weeks of

follow-up.

Result: As of 13.01.23, 44 enrolled pts (Cohort A, n=16; Cohort B, n=28)

received SG + pembro. Median age was 68 y (range 47-80); 64% of pts had

non-squamous histology and 77% had an ECOG of 1. In ecacy-evalu-

able pts (Cohort A n=8; Cohort B n=18), ORR by investigator assessment

was 75% (5 conrmed PRs, 1 PR pending conrmation) in Cohort A and

44% (7 conrmed PRs, 1 PR pending conrmation) in Cohort B. Among

safety-evaluable pts (n=44), the incidence of any-grade treatment-emer-

gent AEs (TEAEs) was 96% (grade 3/4, 52%). Most common any-grade

TEAEs were diarrhea (50%), anemia (41%), asthenia (36%) and neutro-

penia (32%). TEAEs leading to discontinuation of SG occurred in 7% of

pts. TEAEs leading to death were reported in 3 (7%) pts, and only 1 (2%)

was considered related to study treatment.

Discussion/Conclusion: In Cohorts A and B, SG + pembro demonstrated

encouraging early ecacy with a manageable safety prole in pts with

mNSCLC. Additional results with more pts and longer follow up will be

presented.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 245

989

Datopotamab deruxtecan (Dato-DXd) vs docetaxel in

previously treated advanced/metastatic (adv/met) non-small

cell lung cancer (NSCLC): Results of the randomized phase III

study TROPION-Lung01

Akin Atmaca1,1; Myung-Ju Ahn2; Aaron Lisberg3; Luis Paz-Ares4;

Robin Cornelissen5; Nicolas Girard6; Elvire Pons-Tostivint6;

David Vicente Baz4; Shunichi Sugawara9; Manuel Angel Cobo4;

Maurice Pérol6; Céline Mascaux6; Elena Poddubskaya13; Satoru Kitazono9;

Hidetoshi Hayashi9; Jacob Sands3; Richard Hall3; Yong Zhang3;

Hong Zebger-Gong1; Deise Uema3; Isamu Okamoto9; Niels Reinmuth1

1Krankenhaus Nordwest, Frankfurt am Main, Deutschland

2Samsung Medical Center, Sungkyunkwan University School of Medicine Seoul,

Seoul, South Korea

3David Geen School of Medicine at UCLA, Los Angeles, USA

4Hospital Universitario 12 de Octubre, CNIO-H12O Lung Cancer Unit,

Universidad Complutense & CiberOnc, Madrid, Spain

5Erasmus Medical Center Cancer Institute, Rotterdam, Netherlands

6Institut Curie, Paris, France

7Centre Hospitalier Universitaire de Nantes, Nantes, France

8Hospital Universitario Virgen Macarena, Seville, Spain

9Sendai Kousei Hospital, Sendai, Japan

10FEA Oncología Médica. Medical Oncology Intercenter Unit. Regional and

Virgen de la Victoria University Hospitals. IBIMA, Málaga, Spain

11Centre Léon Bérard, Lyon, France

12Hôpitaux Universitaires de Strasbourg (CHRU), Strasbourg, France

13Vitamed LLC, Moscow, Russia

1The Cancer Institute Hospital of JFCR, Tokyo, Japan

15Kindai University, Osaka, Japan

16Dana-Farber Cancer Institute, Boston, USA

17University of Virginia Health System, Charlottesville, USA

18Daiichi Sankyo, Inc, Basking Ridge, USA

19Daiichi Sankyo Europe GmbH, München, Germany

20Kyushu University Hospital, Fukuoka, Japan

21Asklepios Klinik Gauting GmbH, Gauting, Deutschland

Background: Dato-DXd is a novel TROP2-directed antibody-drug con-

jugate under clinical investigation in multiple tumor types. is is the

rst report of TROPION-Lung01 (NCT04656652), a randomized, global,

open-label, phase 3 study of Dato-DXd vs docetaxel (DTX) in pretreated

patients (pts) with adv/met NSCLC with or without actionable genomic

alterations (AGAs).

Methods: Pts were randomized 1:1 to Dato-DXd 6 mg/kg or DTX 75 mg/

m2 Q3W. Dual primary endpoints were progression-free survival (PFS;

by blinded independent central review [BICR]) and overall survival (OS).

Secondary endpoints included objective response rate (ORR), duration of

response (DOR), and safety.

Result: 604 pts were included in the full analysis set (FAS); 43.1% had

received ≥2 prior lines of systemic therapy. Median age was 64 y (range,

24-88). PFS was signicantly improved with Dato-DXd over DTX in

the FAS (HR, 0.75; 95% CI, 0.62-0.91; P=.004; median, 4.4 vs 3.7 mo).

Conrmed ORRs were 26.4% (Dato-DXd) and 12.8% (DTX), with median

DORs of 7.1 and 5.6 mo. Longer median PFS was observed in the prespec-

ied non-squamous histology subgroup (NSQ; 5.6 vs 3.7 mo). Median

treatment duration was 4.2 mo (range, 0.7-18.3 mo) for Dato-DXd and

2.8 mo (range, 0.7-18.9 mo) for DTX. e most common treatment-emer-

gent adverse events (TEAEs) seen with Dato-DXd were stomatitis (49.2%,

mostly grade [gr] 1/2) and nausea (37%). Adjudicated drug-related inter-

stitial lung disease gr ≥3 occurred in 3.4% of pts with Dato-DXd vs 1.4%

with DTX. Fewer drug-related gr ≥3 TEAEs and AEs leading to dose

reduction or discontinuation were seen with Dato-DXd vs DTX.

Conclusion: PFS was signicantly improved with Dato-DXd over DTX

in pts with pretreated adv/met NSCLC. NSQ patients appeared to derive

the most benet. Dato-DXd was well tolerated, with a manageable safety

prole. e trial is continuing until the nal OS analysis. M-J. Ahn and A.

Lisberg have equally contributed to the study. Funding Daiichi Sankyo, Inc.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

999

Overalls Survival from a Phase II Randomised Double-Blind

Trial (PERLA) of Dostarlimab (dostar) + Chemotherapy (CT) vs

Pembrolizumab (pembro) + CT in Metastatic Non-Squamous

NSCLC

Solange Peters1; Frank Griesinger2; Ana Laura Ortega Granados3;

Filippode Marinis4; Giuseppe Lo Russo5; Michael Schenker6;

EdurneArriola7; Juan Manuel Puig8; Dae Ho Lee9; Martin Reck10;

ZsoltSzijgyarto11; Elena Buss12; Neda Stjepanovic13; Sun Min Lim14

1Oncology Department, Centre Hospitalier Universitaire Vaudois, Lausanne

University, Lausanne, Switzerland

2Department of Hematology and Oncology, Pius-Hospital Oldenburg, University

Medicine Oldenburg, Oldenburg, Germany

3Medical Oncology Department, Hospital Universitario de Jaén, Jaén, Spain

4Division of Thoracic Oncology, Istituto Europeo di Oncologia (IRCCS), Milan,

Italy

5Medical Oncology Department, Thoracic Unit, Fondazione IRCCS Istituto

Nazionale dei Tumori, Milan, Italy

6Oncologie Medicala, Policlinica Sf. Nectarie, Centrul de Oncologie, Craiova,

Romania

7Hospital del Mar, Parc de Salut Mar, Barcelona, Spain

8Oncología, Centro Polivalente de Asistencia e Investigación Clínica, CER San

Juan, San Juan, Argentina

9Department of Oncology, University of Ulsan, College of Medicine, Asan

Medical Center, Seoul, South Korea

10Lungen Clinic, Airway Research Center North, Center for Lung Research,

Grosshansdorf, Germany

11GSK, Stevenage, UK

12GSK, Baar, Switzerland

13GSK, Baar, Switzerland

14Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center,

Severance Hospital, Yonsei University College of Medicine, Seoul, Korea

Background: e Phase II PERLA trial (NCT04581824) was the rst

global randomized, double-blind, head-to-head study of two programmed

death (PD)-1 inhibitors in NSCLC. In the primary analysis, dostar + CT

met its primary endpoint of equivalence, with a favorable numerical trend

in overall response rate (ORR) and progression-free survival compared to

pembro + CT. Here we report overall survival (OS) analyses from PERLA.

Methods: Patients (pts) with metastatic NSCLC, documented PD-L1

status, absence of EGFR, ALK or other actionable genomic aberrations

determined locally, ECOG 0–1, and no prior systemic treatment were ran-

domised 1:1 to dostar 500 mg or pembro 200 mg Q3W IV up to 35 cycles,

combined with CT (4 cycles pemetrexed [pem; 500 mg/m2] + carboplatin

[AUC 5 mg/mL/min] or cisplatin [75 mg/m2], followed by pem up to 35

cycles) Q3W IV. e primary endpoint was ORR by blinded independent

central review (BICR). OS (secondary endpoint) and duration of response

(DoR) by BICR (exploratory endpoint) were determined by Kaplan-Meier

method, 95% condence intervals (CIs) by Brookmeyer-Crowley method

and hazard ratio by stratied Cox proportional hazard model.

Results: At data cut-o on 07 July 2023, 121 and 122 pts in the dostar +

CT and pembro + CT arms respectively, were randomised and treated. OS

maturity was 55% (134/243). Median OS was 19.4 mo (95% CI 14.5, NR)

in the dostar + CT arm vs 15.9 mo (95% CI 11.6, 19.3) in the pembro +

CT arm, aer median follow-up (IQR) of 20.7 (17.3, 24.0) and 21.6 (18.3,

24.1) mo respectively, with a similar trend across PD-L1 subgroups. e

ORR for Dostar + CT was 45% (95% CI: 36.4, 54.8) (4 CRs, 51 PRs), show-

ing a 6.04% dierence [95% CI: -1.95, 14.02] compared to 39% (95% CI:

30.6, 48.6) in Pembro + CT (6 CRs, 42 PRs).e median DoR in Dostar +

CT was 12.4 mo (95% CI: 8.3, 17.9), while in Pembro + CT, it was 14.4 mo

(95%CI: 9.7, NR) No new safety concerns were raised.

Conclusions: In this follow-up analysis, dostar + CT continues to demon-

strate strong clinical ecacy with no unexpected safety signals. In addi-

tion, a numerical trend in OS favoring dostar + CT vs pembro + CT was

observed.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts246

1108

Randomized phase 3 study of rst-line selpercatinib versus

chemotherapy and pembrolizumab in RET fusion-positive

NSCLC

Herbert Loong1; Koichi Goto2; Benjamin Solomon3; Keunchil Park4;

Maurice Pérol5; Edurne Arriola6; Silvia Novello7; Ying Cheng8;

AndreaArdizzoni9; Milena Mak10; Fernando Santini11; Yasir Elamin12;

Alexander Drilon11; Jürgen Wolf13; Baohui Han14; Hongmei Han15;

MinjiUh16; Tarun Puri16; Viktoriya Soldatenkova16; Caicun Zhou17

1Hong Kong University, Hong Kong, China, VR

2National Cancer Center Hospital East, Kashiwa, Japan

3Peter MacCallum Cancer Centre, Melbourne, Australien

4Samsung Medical Center, Seoul, Republik Korea

5Léon Bérard Center, Lyon, Frankreich

6Hospital del Mar, Barcelona, Spanien

7Università degli Studi di Torino, Torino, Italien

8Jilin Cancer Hospital, Changchun, China, VR

9IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italien

10Instituto D’Or de Pesquisa e Ensino: Faculdade, Pós-Graduação, MBA, São

Paulo SP, Sao Paulo, Brasilien

11Memorial Sloan-Kettering Cancer Center, New York, USA

12University of Texas MD Anderson Cancer Center, Houston, USA

13Uniklinik Köln, Köln, Deutschland

14Jiaotong-Universität Shanghai, Shanghai, China, VR

15Eli Lilly, Indianapolis, USA

16Eli Lilly and Company Corporate Center, Indianapolis, USA

17Tongji University Aliated Shanghai Pulmonary Hospital, Shanghai, China, VR

Background: Selpercatinib is a highly selective and potent brain penetrant

RET inhibitor, approved for treatment of advanced RET fusion-positive

(RET+) NSCLC.

Methods: LIBRETTO-431 (NCT04194944) is a randomized, open-label,

phase 3 trial comparing rst-line selpercatinib vs chemotherapy (cispla-

tin/carboplatin + pemetrexed) +/- pembrolizumab. e primary endpoint

of blinded independent central review (BICR)-assessed PFS was tested

rst in patients stratied by investigator’s intent to treat with pembroli-

zumab, if assigned to the control arm, (ITT-pembro) and then in the ITT

population.

Result: A total of 261 patients were enrolled from 23 countries. At a

median follow up of ~19 months, selpercatinib demonstrated superior

PFS vs control in the ITT-pembro (HR: 0.465, 95% CI: 0.309, 0.699;

p-value: 0.0002) and ITT populations (HR: 0.482, 95% CI: 0.331, 0.700;

p-value: 0.0001). In the ITT-pembro population, median PFS was 24.8

months (95% CI: 16.9, NE) with selpercatinib vs 11.2 months (95% CI:

8.8, 16.8) with control. Clinically meaningful improvements in ORR,

DOR, and intracranial response were also observed with selpercatinib vs

control. Adverse events observed with selpercatinib and the control arm

were generally consistent with those previously reported.

Discussion: Selpercatinib achieved a statistically signicant and clinically

meaningful improvement in PFS compared to chemotherapy + pembroli-

zumab in advanced RET+ NSCLC.

Conclusion: ese data support comprehensive genomic testing at diag-

nosis and treatment with rst-line selpercatinib in patients with advanced

RET+ NSCLC.

Disclosure Statement: e authors declare the following: Mitglied in Beratungs-

gremine, Forschungsunterstützungen, Drittmittel

1131

Patient-reported outcomes of rst-line selpercatinib versus

chemotherapy with or without pembrolizumab in ret fusion-

positive advanced non-small-cell lung cancer: interim analysis

of LIBRETTO-431

Koichi Goto1; Silvia Novello2; Pilar Garrido3; Christophe Dooms4;

JorgeAlatorre-Alexander5; Niels Reinmuth6; Adrienne Gilligan7;

NalinPayakachat7; Aimee Bence-Lin7; Kim Cocks8; Gill Worthy8;

CaicunZhou9

1National Cancer Center Hospital East, Kashiwa, Japan

2Università degli Studi di Torino, Torino, Italien

3Ramón y Cajal Hospital, Madrid, Spanien

4Department of Respiratory Diseases, University Hospitals KU Leuven, Leuven,

Belgien

5Health Pharma Professional Research S.A de C.V., Ciudad de México, Mexiko

6Asklepios Lung Clinic, member of the German Center for Lung Research (DZL),

Munich-Gauting, Deutschland

7Eli Lilly and Company Corporate Center, Indianapolis, USA

8Adelphi Values, Bollington, United Kingdom

9Tongji University Aliated Shanghai Pulmonary Hospital, Shanghai, China, VR

Background: Selpercatinib, a highly selective and potent CNS penetrant

RET inhibitor has been approved for treatment of advanced RET fusion+

non-small-cell lung cancer (NSCLC). LIBRETTO-431 (NCT04194944),

is a randomized, phase 3 trial comparing rst-line selpercatinib to plat-

inum-based chemotherapy +/- pembrolizumab (pembro). is analysis

describes the patient-reported outcomes (PROs) from LIBRETTO-431.

Methods: PRO data (data cut-o: 01 May 2023) were evaluated for the

intent-to-treat (ITT) population and the subgroup of patients that received

pembro (ITT-pembro). Time to conrmed deterioration (TTCD) of pul-

monary symptoms (using NSCLC-Symptom Assessment Questionnaire

[SAQ]) and physical function (using EORTC QLQ-C30 Physical Function

scale [QLQ-C30 PF]) was time from randomization to the rst ≥2 point

increase of NSCLC-SAQ total score or ≥5 point decrease in QLQ-C30

PF, conrmed at next assessment. TTCD was compared between treat-

ment groups using log rank test and Cox proportional hazards model.

Symptomatic adverse events (using PRO version of the CTCAE item

library) were reported descriptively as baseline-adjusted worst score.

PROs were also analyzed for East Asia vs. non-East Asia subgroups.

Result: In ITT-pembro (selpercatinib n=129 and control n=83), selper-

catinib delayed TTCD of pulmonary symptoms (hazard ratio [HR]=0.34,

95% CI: 0.20-0.55) and physical function (HR=0.54, 95% CI: 0.39-0.75).

Patients in the selpercatinib arm reported worse PRO-CTCAE scores of

dry mouth, diarrhea, and arm/leg swelling, whereas those in the control

arm reported worse scores of nausea, fatigue, and decreased appetite.

Results were consistent in the ITT population. PROs were similar between

East Asia and non-East Asia subgroups.

Discussion: PRO data were consistent with the favorable ecacy of selp-

ercatinib compared with platinum-based chemotherapy +/- pembro.

Conclusion: Selpercatinib signicantly delayed TTCD of pulmonary

symptoms and physical function and was well-tolerated in these patient

populations.

Disclosure Statement: e authors declare the following: Mitgliedscha in Bera-

tungsgremien, Forschungsunterstützung, Drittmittel

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 247

Molecular Pathology

1129

Targeted RNAseq Analysis in Esophageal Cancers:

Implications for Neoadjuvant Therapy

Michelle Schulz1; Nadine Dexheimer2; Silke Mitschke2; Wilfried Roth2;

Michael Kloth2

1Klinik für Kinder- und Jugendmedizin, Klinikum der Goethe-Universität

Frankfurt am Main, Frankfurt am Main, Deutschland

2Institut für Allgemeine Pathologie, Universitätsmedizin der Johannes

Gutenberg- Universität Mainz, Mainz, Deutschland

Background: Esophageal adenocarcinoma (AC) and squamous cell car-

cinoma (SCC) frequently present with poor prognoses. is study aims

to evaluate the feasibility and prognostic signicance of targeted RNA

sequencing (RNAseq) in biopsy samples from these carcinomas, aiming

to rise a nuanced understanding of tumor biology and treatment response

by a more detailed pretherapeutic expression proling.

Methods: A retrospective analysis was conducted on paran-embed-

ded biopsy samples from patients who underwent neoadjuvant therapy,

that allowed a comparison of molecular proles pre- and post-treatment.

Prognostic modeling was performed using a machine learning-based

approach, leveraging gene expression data. It included pathway enrich-

ment analysis to elucidate underlying biological mechanisms.

Results: e feasibility of conducting RNAseq on small biopsy samples

was demonstrated, eectively distinguishing between SCC and AC sub-

types. SCCs were found to respond better to neoadjuvant treatment and

show a higher 5-year survival rate compared to ACs. Several prognostic

genes and pathways were identied, some of which may represent novel

ndings in the context of esophageal cancers. e machine learning

model identied a gene signature that signicantly enhanced prognostic

predictions.

Discussion: e ability to dierentiate between carcinomas using

RNAseq and to identify prognostic markers has signicant clinical impli-

cations. is approach enhances tumor molecular characterization, lead-

ing to more personalized and eective treatments. RNAseq complements

immunohistochemical quantication of markers like Her2/ERBB2 and

PD-L1, oering a more comprehensive molecular prole of tumors.

Conclusion: is study highlights the practicality and prognostic value

of targeted RNAseq in esophageal transition zone carcinomas but also

underscores its potential applicability in advancing personalized oncol-

ogy. Such insights pave the way for improved patient stratication and

personalized neoadjuvant therapy approaches in esophageal cancers.

Disclosure Statement: e authors declare no conict of interest.

Novel Therapeutics: Targeted Therapies,

Immunotherapies, Cellular Therapies

1060

Idecabtagene Vicleucel (ide-cel) versus Standard (std)

Regimens in Patients (pts) with Triple-class–Exposed (TCE)

Relapsed and Refractory Multiple Myeloma (RRMM): Updated

Analysis from KarMMa-3

Christoph Scheid1; Paula Rodríguez-Otero2; Sikander Ailawadhi3;

BertrandArnulf4; Krina Patel5; Michele Cavo6; Ajay K. Nooka7;

SalomonManier8; Natalie Callander9; Luciano J. Costa10; Ravi Vij11;

NizarJBahlis12; Philippe Moreau13; Scott R. Solomon14;

IngeridWeumAbrahamsen15; Rachid Baz16; Annemiek Broijl17;

ChristineChen18; Sundar Jagannath19; Noopur Raje20; Michel Delforge21;

Reuben Benjamin22; Thomas Pabst23; Shinsuke Iida24; Jesús Berdeja25;

Anna Truppel-Hartmann26; Rashmi Bhatnagar27; Fan Wu28;

JuliaPiasecki28; Laurie Eliason28; Devender Dhanda28; Jasper Felten28;

Andrea Caia28; Mark Cook29; Mihaela Popa Mckiver28; Sergio Giralt30

1University of Cologne, Cologne, Deutschland

2Clínica Universidad de Navarra, Pamplona, Spanien

3Mayo Clinic, Jacksonville, USA

4Université Paris Cité, Paris, Frankreich

5University of Texas, Houston, USA

6Bologna University School of Medicine, Bologna, Italien

7Emory University, Atlanta, USA

8Université de Lille, Lille, Frankreich

9University of Wisconsin, Madison, USA

10University of Alabama at Birmingham, Birmingham, USA

11Washington University School of Medicine in St. Louis, St. Louis, USA

12University of Calgary, Calgary, Kanada

13University Hospital of Nantes, Nantes, Frankreich

14Northside Hospital Cancer Institute, Atlanta, USA

15Oslo University Hospital, Oslo, Norwegen

16Mott Cancer Center, Tampa, USA

17Erasmus MC Cancer Institute, Rotterdam, Niederlande

18Princess Margaret Hospital, Toronto, Kanada

19Mount Sinai Medical Center, New York, USA

20Massachusetts General Hospital, Boston, USA

21Universitaire Ziekenhuizen Leuven, Leuven, Belgien

22Kings College Hospital, London, United Kingdom

23Bern University Hospital, Bern, Schweiz

24Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan

25Sarah Cannon Research Institute, Nashville, USA

262seventy bio, Cambridge, USA

27Syneos Health, Haryana, Indien

28Bristol Myers Squibb, Princeton, USA

29Bristol Myers Squibb, Boudry, Schweiz

30Memorial Sloan Kettering Cancer Center, New York, USA

Background: Interim analysis of the phase 3 KarMMa-3 trial

(NCT03651128) revealed consistent ide-cel benets across TCE RRMM

pts including high-risk subgroups, with safety data comparable to pre-

vious studies. Results of the nal progression-free survival (PFS) and

interim OS analysis with longer follow-up are reported.

Methods: RRMM pts who received 2–4 prior regimens, including an

immunomodulatory agent, proteasome inhibitor and daratumumab, and

were refractory to last regimen were randomized 2:1 to ide-cel or a std

regimen. Primary endpoint was IRC-assessed PFS in the ITT population.

Key secondary endpoints were IRC-assessed overall response rate (ORR)

and overall survival (OS).

Results: Baseline characteristics of 386 randomized pts (ide-cel, n = 254;

std regimens, n = 132) were balanced. Median follow-up from randomiza-

tion to data cuto was 30.9 mo (12.7–47.8). Ide-cel signicantly improved

median PFS (95% CI) vs std regimens (13.8 [11.8–16.1] vs 4.4 [3.4–5.8]

mo), representing a 51% reduced risk of PD or death; in pts. treated with

ide-cel (n = 225) or std regimen (n = 126), median PFS (95% CI) was

15.7 (12.5–18.9) vs 4.4 (3.4–5.8) mo. Ide-cel signicantly improved ORR

vs std regimens (71% vs 42%) with deeper (CRR 44% vs 5%) and more

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts248

durable responses (median DOR 16.6 vs 9.7 mo). In the treated popula-

tion, grade (gr) 3/4 infections occurred in 27% pts in the ide-cel vs 20%

in the std regimens arm. In the ide-cel safety population, any gr cytokine

release syndrome occurred in 88% pts (gr ≥ 3 in 5%), and neurotoxicity in

15% (gr ≥ 3 in 3%). Pt-reported outcomes revealed clinically meaningful

improvements.

Discussion: is nal PFS analysis of KarMMa-3 demonstrated a sig-

nicantly longer PFS and a 51% risk reduction of PD or death with ide-

cel; responses were deeper and more durable vs std regimens. e safety

prole was consistent with previous reports, and no parkinsonism or

Guillain–Barré syndrome was reported.

Conclusion: ese data continue to support use of ide-cel in TCE RRMM

(2023). Reused with permission.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

969

Novel YAP1/TAZ pathway inhibitors identied through

phenotypic screening with potent anti-tumor activity via

blockade of GGTase-I / Rho-GTPase signaling

Martin Lange1,2

1Nuvisan ICB GmbH, Berlin, Deutschland

2Bayer Pharma AG, Berlin, Deutschland

Background: is study describes the identication and target deconvo-

lution of novel small molecule inhibitors of oncogenic YAP1/TAZ activity

with anti-tumor activity in vivo. YAP1/TAZ have been shown to be aber-

rantly activated oncogenes in human tumors, resulting in enhanced cell

proliferation, metastasis and provision of a pro-tumorigenic microenvi-

ronment, making YAP1/TAZ targets for novel cancer therapies.

Methods: A high-throughput screen (HTS) of 3.8 million compounds

was conducted using a cellular YAP1/TAZ reporter assay. HTS hits that

selectively inhibited TEAD-luciferase, but not TK-Renilla-luciferase were

subsequently assessed regarding their ability to induce translocation of

YAP1 from the nucleus to the cytoplasm in MDA-MB-231 cells. Out of

these, a subset of hits showed activity to induce translocation of YAP1.

Finally, selected hits active in both assays were assessed regarding their

eect on endogenous YAP1/TAZ target genes.

Result: e small molecule BAY-856 demonstrated the most consistent

YAP1/TAZ inhibitory activity of all selected hits, which warranted fur-

ther exploration of the unknown direct drug target. Target deconvolution

studies identied the geranylgeranyltransferase I (GGTase I) complex,

as the direct target of YAP1/TAZ pathway inhibitor BAY-856. BAY-856

blocked the activation of Rho-GTPases, leading to subsequent inactiva-

tion of YAP1/TAZ and inhibition of cancer cell proliferation in several

tumor types in vitro. Multi-parameter optimization resulted in BAY-593,

an in vivo probe with favorable PK properties. BAY-593 demonstrated

anti-tumor activity in solid tumor models and blockade of YAP1/TAZ

signaling in vivo.

Discussion: We show that phenotypic screening is a viable strategy to

identify novel small molecules when combined with a matching target

deconvolution strategy.

Conclusion: Our lead molecule BAY-593 is a novel tool compound to

explore Rho-GTPase signaling and downstream YAP1/TAZ biology in

vitro and in vivo.

Indication of source:

1 is study was funded by Bayer Pharma AG

Disclosure Statement: e authors declare the following: is study was funded

by Bayer Pharma AG

Onkologische Pege

973

Analyse der speziellen pegerischen Versorgungssituation

von Adolescents und young Adults im Rahmen einer

onkologischen Erkrankung

Melisa Dietrich1

1Universitätsklinikum Essen, Essen, Deutschland

Background: Adolescents and young Adults (AYA) mit einer onkol-

ogischen Erkrankung sind eine besondere Patient*innengruppe mit

speziellen Bedürfnissen. Diese sind bedingt durch die normativen phy-

sischen als auch psychosozialen Entwicklungsschritten, welche durch das

Aureten einer onkologischen Erkrankung und den damit einhergehen-

den Komplikationen eingeschränkt werden.

Methods: Als Methodik wurde eine Literaturrecherche im Rahmen der

Erstellung einer Bachelorabschlussarbeit (B.Sc.) gewählt. Es wurde mit

den MESH Terms „AYA“, „Adolescents and young adults“, gepaart mit den

Begrien „cancer“, „oncology“ oder „needs“ oder „nurse“ und „nursing“

gesucht. Hierzu wurden die Datenbanken PubMed und CINAHL genutzt.

Result: AYAs mit einer onkologischen Erkrankung haben altersentspre-

chende und entwicklungsabhängige Bedürfnisse, welche nicht adäquat

in der klinischen Praxis wahrgenommen werden. Sie fühlen sich nicht

ausreichend in Entscheidungsprozesse ihrer erapie eingebunden.

Außerdem ndet Aulärung und Beratung durch das multiprofessionelle

Behandlungsteam nicht bedarfsdeckend statt. Dies inkludiert emen wie

Sexualität, Fertilitätserhalt, Survivorship und Nachsorge. Zusätzlich emp-

nden AYAs ein ausgeprägtes Bedürfnis nach Kontakt zu Gleichaltrigen

in einer ähnlichen Lebenssituation (peers).

Discussion: Es wurde festgestellt, dass AYAs, im Vergleich zur jün-

geren und älteren Patientenkohorten, weniger als einzigartige

Patient*innengruppe wahrgenommen werden und deshalb weniger über

ihre speziellen Bedürfnisse bekannt ist. Es besteht ein ausgeprägter Bedarf

an Informationsmaterialien und Beratungskonzepten speziell für AYAs.

Die Behandlungsteams sollten im Umgang und Kommunikation mit

AYAs gezielt geschult werden.

Conclusion: AYAs haben spezielle Bedürfnisse, die aber nicht bei allen

Behandelnden bekannt sind und kommuniziert werden. Es gibt Bedarfe

zur Optimierung der Versorgungsstrukturen um unter anderem eine ver-

besserte Informationsweitergabe für die Patient*innen.

Disclosure Statement: e authors declare no conict of interest.

1019

"Da fehlt einfach jemand der das Ganze koordiniert

zwischen der OP und der anschließenden Chemotherapie"

– Tätigkeitsfeld einer Advanced Practice Nurse in der

Neuroonkologie

Lea Kaumann1; Regina Schmeer1

1Medizinische Hochschule Hannover, Hannover, Deutschland

Background: Das Belastungserleben von Patient:innen mit neuroonkol-

ogischen Erkrankungen sowie deren An- und Zugehörige ist sehr hoch.

Im Zentrum der Fragestellungen steht omals wie mit der Erkrankung

im Alltag umgegangen werden kann insbesondere vor dem Hintergrund

schlechter Prognosen und begrenzter Behandlungsmöglichkeiten.

Methods: Die MHH implementierte im Januar 2017 eine Advanced

Practice Nurse (APN) auf einer neurochirurgischen Station um die

Versorgungslücke der neuroonkologischen Patient:innen zu schließen.

Die Beratungs- und Versorgungsbedarfe wurden in leitfadengestützten

Interviews und einer standardisierten Befragung erhoben. Die implemen-

tierten Maßnahmen wurden anschließend evaluiert.

Result: In den leitfadengestützten Interviews wurde deutlich, dass die

Patient:innen aufgrund der neuen Situation viel Beratung und Anleitung

zur Krankheitsbewältigung benötigen. Insbesondere wenn es sich um einen

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 249

malignen Tumor mit einer weiterführenden erapie handelt und eine neu

aufgetretene Pegebedürigkeit hinzukommt. Versorgungsdezite wurden

in der Struktur der Beratung und Anleitung sowie im Einbezug der An- und

Zughörigen wahrgenommen. Besonders der Entlassungsprozess wurde als

unstrukturiert erlebt. Daher wurden eine aufsuchende Pegeberatung, eine

strukturierte Entlassungsplanung und interdisziplinäre Fallbesprechungen

als Tätigkeiten der APN implementiert.

Discussion: Die Evaluation zeigte, dass die implementierten Maßnahmen

der APN von den Patient:innen gut angenommen wird. Die aufsuchende

Pegeberatung sowie die strukturierte Entlassungsplanung werden als

sehr hilfreich erlebt und führen zu einer größeren Handlungssicherheit.

Conclusion: Die Erhebung zeigt, dass sich Patientenoutcomes durch den

Einsatz einer Advanced Practice Nurse verbessern.

Disclosure Statement: e authors declare no conict of interest.

Other Topics

1005

Current reporting practice of sex and gender in cancer clinical

trials with a patient-reported outcome endpoint: a systematic

review

Daniela Krepper1; Anna Thurner1; Lisa Wintner1; Monika Sztankay1

1University Hospital of Psychiatry II, Department of Psychiatry, Psychotherapy,

Psychosomatics, and Medical Psychology, Medical University Innsbruck,

Innsbruck, Österreich

Background: Sex and gender are acknowledged as pivotal variables in

clinical research. However, the dierences between both concepts are

oen overlooked in medical research resulting in limited generalizabil-

ity of ndings and potential bias. is review portrays current reporting

of sex and/or gender in cancer clinical trials including a patient-reported

outcome endpoint, with an emphasis on linguistic precision.

Methods: Pubmed was searched to identify randomized controlled trials

in patients with bladder, colorectal, and lung cancer, published between

2019 and February 2022. A double-review procedure was applied via

DistillerSR. e data extraction form included information on the

terms used to describe sex and/or gender. e Sex and Gender Equity in

Research (SAGER) Guidelines Checklist was applied for quality appraisal.

Result: e Pubmed search resulted in 2450 identied records, of which

184 proved to be eligible. e term sex was used in 54.9%, gender in

21.2%, and both terms in 17.4% of the trials, while 6.5% reported none.

39.1% of trials used the terms sex and/or gender appropriately (i.e. refer-

ring to biological or social categories) and consistently. 60.9% of trials

combined the terms in varying ways, which was not due to reporting of

both concepts, but rather to synonymous use. In terms of compliance with

the SAGER Guidelines Checklist, the median number of items meeting

the requirements was 2 out of 17.

Discussion: Our review shows that most trials lack linguistic precision

in reporting sex and/or gender, portraying the educational need for these

dierent concepts in the eld of clinical trials with PRO endpoints. e

synonymous use of the terms sex and gender does not do justice to their

dierent conceptualizations and might only contribute to further confu-

sion instead of promoting the imperative inclusion of these biological and

social concepts in medical research.

Conclusion: Raising awareness and compliance with existing SAGER

guidelines in cancer clinical trials would enhance the credibility of con-

clusions drawn regarding sex and/or gender dierences.

Disclosure Statement: e authors declare no conict of interest.

1112

Realization of a virtual multidisciplinary tumor board:

Asolution for the future?

Matthias Zipp1; Sandra Gottschling2; Christoph Schäfer1;

Hans-Ulrich Braner3; Kia Homayounfar2

1Gesundheit Nordhessen Holding AG, Kassel, Deutschland

2Klinikum Kassel, Kassel, Deutschland

3Kreisklinik Hofgeismar, Hofgeismar, Deutschland

Background: Multidisciplinary Tumor Boards (MTB) represent the

gold-standard of decision making in oncology. However, increasing ther-

apeutic options and quality requirements challenge the manpower and

nancial resources for conducting MTB. Digital solutions like virtual

MTB (vMTB) may provide a time saving and cost-ecient alternative

especially for participants from dierent sites. However, in the EU and in

Germany, data protection requirements are high. General Data Protection

Regulation (GDPR) compliance severely restricts the choice of possible

systems.

Methods: For optimal interaction of participants, a two-way transmission

of image and sound is required. is was met by Zoom Rooms. e sys-

tem was initially installed on a PC and later transferred to a neat.bar pro

appliance for easier handling. Finally, it shows all participants, imaging

of the patient and Hospital Information System (HIS) on three screens.

Result: We have been holding a weekly vMTB for four months. e par-

ticipants were trained and needed little support at the beginning. We

currently have one permanent participating hospital. e high quality of

image and sound enables face-to-face-like discussion. e special chal-

lenge is end-to-end-encryption (E2EE) under control of the leading hos-

pital and its ease of use at the same time.

Discussion: e vMTB consists of both, the digital transfer of patient

data from dierent sites into the HIS and the actual virtual conference.

While we established a well-functioning GDPR-approved conference sys-

tem with high acceptance along with only a Zoom client installation at

participating sites, the digital data transfer process is still demanding due

to the lack of interfaces to the HIS and uncertainty with regard to data

protection at external sites.

Conclusion: e vMTB oers substantial advantages compared to MTB,

especially for the participants at external sites. GDPR compliance must

be ensured any time. We are planning to expand to further sites as well as

dierent entities next year.

Disclosure Statement: e authors declare no conict of interest.

1011

Establishing thresholds for clinical importance for disease-

specic EORTC questionnaire modules

Anna Thurner1; Micha Pilz1; Juan I. Arraras2; Renee Bultijnck3; Kelly de Ligt4;

Fabio Ecace5; Tihana Gašpert6,7; Mogens Groenvold8; Bernhard Holzner1;

Jörg Andreas Müller9; Katarzyna Pogoda10; John Ramage11;

HeikeSchmidt9; Teresa Young12; Johannes Giesinger1

1University Hospital of Psychiatry II, Department of Psychiatry, Psychotherapy,

Psychosomatics, and Medical Psychology, Innsbruck Medical University,

Innsbruck, Österreich

2Hospital of Navarre, Pamplona, Spanien

3Ghent University Hospital, Ghent, Belgien

4Department of Psychosocial research and Epidemiology, Amsterdam, Niederlande

5Italien Group for Adult Hematologic Diseases (GIMEMA) Data Center, Rome, Italien

6Nursing Home Mali Kartec, Krk, Kroatien

7Faculty of Health Sciences, University of Maribor, Maribor, Slovenia

8University of Copenhagen, Copenhagen, Dänemark

9University Hospital Halle (Saale), Halle (Saale), Deutschland

10Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Polen

11Hampshire Hospitals NHS Foundation Trust, Basingstoke, United Kingdom

12Mount Vernon Cancer Centre, Northwood, United Kingdom

Background: e patient-reported outcome (PRO) measures developed

by the European Organisation for Research and Treatment of Cancer

(EORTC) Quality of Life Group are the most widely used questionnaires

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts250

for assessing the patients’ perspective on cancer and cancer treatment.

To facilitate PRO interpretation, our study aims to establish threshold

scores for clinical importance (TCIs) for eight disease/population-spe-

cic EORTC questionnaire modules that target the most prevalent cancer

types in Europe.

Methods: For this prospective study we are recruiting 225 cancer patients

at ten European centres for each of the following eight groups: elderly

patients and patients with breast, prostate, colorectal, endometrium, lung,

head and neck, and ovarian cancer. Patients participating in the study

completed the respective EORTC module and answered anchor questions

on predened aspects of clinical importance (emotional burden, limita-

tions of daily life, and need for help) related to each of the assessed health

domains.

Results: At the time of abstract submission, we have recruited 370 cancer

patients, and initial results are already available for the EORTC module

for elderly cancer patients. ese results indicate that the EORTC mod-

ules provide high diagnostic accuracy for the identication of clinically

important health issues with an area under the curve and sensitivity for

selected thresholds above 0.80 for the assessed health domains. Latest

study results will be presented at the conference.

Discussion: e initial results align with the previous study on TCIs for

the EORTC QLQ-C30 cancer questionnaire (Giesinger et al., 2020, J Clin

Epidemiology) that also demonstrated high diagnostic accuracy for iden-

tication of clinically important health issues.

Conclusion: In conclusion, the results from our study will facilitate the

interpretation of PRO scores obtained via the EORTC questionnaires. e

TCIs may support symptom screening and monitoring in daily clinical

practice, and be used for responder denition in clinical trials.

Disclosure Statement: e authors declare no conict of interest.

Primary and Secondary Prevention

1063

UCan: Unveiling the Power of Prevention – Insights from

aBaseline Analysis

Antonia von Ellerts1; Ulrike Haidn1; Theres Fey1; Sebastian Theurich2;

Enrico N. De Toni3; Volker Heinemann1,4; Nicole Erickson1

1Comprehensive Cancer Center (CCC Munich LMU), Ludwig Maximilian

University (LMU) Hospital Munich, München, Deutschland

2Department of Medicine III, Ludwig Maximilian University (LMU) Hospital

Munich, München, Deutschland

3Department of Medicine II, Ludwig Maximilian University (LMU) Hospital

Munich, München, Deutschland

4Comprehensive Cancer Center Munich (CCC Munich), München, Deutschland

Background: Cancer prevention through lifestyle modication has been

identied as a priority in Europe’s Beating Cancer Plan and is detailed in

the European Code Against Cancer (ECAC) (1). 30-50% of cancer cases

could potentially be prevented through lifestyle changes (2). As role mod-

els, healthcare professionals and medical students must recognize the pre-

ventive potential of the ECAC and actively practice what they advocate.

Methods: A baseline awareness survey was conducted among hospital

sta and medical students (Sept 23 - Dec 23). Based on Perula-de Torres

et al. (2021) (3), we hypothesized that 50% of the population will name

≥6/12 points from the ECAC correctly.

Result: 2964 subjects participated. At least half of the study population

is not aware of ≥2 points of the ECAC recommendations and a third of

the subjects named ≥2 points that were not backed by adequate evidence.

Only 64% report regularly undergoing screening measures. 50% failed to

acknowledge the cancer preventative potential of immunizations. Only

16% consume the recommended portions of vegetables (≥3) and 30%

consume ≥2 portions of fruit. 30% fell below the recommended physical

activity guidelines.

Discussion: While many demonstrate basic health knowledge, concern-

ing disparities remain between awareness and practice. is highlights

the need for interventions to close this gap and encourage lasting change,

especially among healthcare professionals.

Conclusions: Essential information gaps exist regarding the ECAC

knowledge and implementation. Results will inform content development

for a pre and post intervention study design evaluating ECAC awareness

and behaviour changes.

Indication of source:

1. IARC. (2016). European Code Against Cancer. WHO. https://cancer-code-

europe.iarc.fr/index.php/en/ (14.12.23)

2. WHO. (2023). Preventing cancer. https://www.who.int/activities/preventing-

cancer (14.12.23)

3. Perula-de Torres et al. (2021). Awareness of the European Code Against Cancer

of Family Medicine Residents and Nursing and Medicine Students in Spain. J

Cancer Educ, 36(5), 1069-1074.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

979

The establishment of a German Reference Network for

Hereditary Tumor Syndromes to implement the European

Reference Network achievements into a national health care

system

Stefan Aretz1,2,3; Nadine Weinstock4; Christian Kratz5; Alexander Volk3,6;

Isabel Spier1,2,3; Miriam Elbracht7; Christian Sutter8; ChristopherSchroeder9;

Reiner Siebert10; Nicola Reents11; André Reis3,12,13; Evelin Schröck3,14,15;

LorenzGrigull4; Tim Ripperger3,16; VerenaSteinke-Lange3,17,18;

ElkeHolinski-Feder3,17,18

1Institute of Human Genetics, Medical Faculty, University of Bonn, Bonn,

Deutschland

2Center for Hereditary Tumor Syndromes, University Hospital Bonn, Bonn,

Deutschland

3European Reference Network on Genetic Tumour Risk Syndromes (ERN

GENTURIS), Nijmegen, Niederlande

4Centre for Rare Diseases, University Hospital Bonn, Bonn, Deutschland

5Pediatric Hematology and Oncology, Hannover Medical School, Hannover,

Deutschland

6Institute of Human Genetics, University Medical Center Hamburg-Eppendorf,

Hamburg, Deutschland

7Institute for Human Genetics and Genomic Medicine, Medical Faculty, RWTH

Aachen University, Aachen, Deutschland

8Institute of Human Genetics, University Hospital Heidelberg, Heidelberg,

Deutschland

9Institute of Medical Genetics and Applied Genomics, University Hospital

Tübingen, Tübingen, Deutschland

10Institute of Human Genetics, Ulm University and Ulm University Medical

Center, Ulm, Deutschland

11SemiColon – Lynch-Syndrome Patient Network, Mönchengladbach,

Deutschland

12Institute of Human Genetics, University Hospital Erlangen, Friedrich-Alexander

Universität Erlangen-Nürnberg, Erlangen, Deutschland

13Centre for Rare Disorders Erlangen (ZSEER), University Hospital Erlangen,

Erlangen, Deutschland

14Translational Medical Oncology, Faculty of Medicine and University Hospital

Carl Gustav Carus, Technische Universität Dresden, Dresden, Deutschland

15Institute for Clinical Genetics, University Hospital Carl Gustav Carus,

Technische Universität Dresden and Hereditary Cancer Syndrome Center

Dresden, Dresden, Deutschland

16Department of Human Genetics, Hannover Medical School, Hannover,

Deutschland

17MGZ - Medical Genetics Center, München, Deutschland

18Arbeitsgruppe erbliche gastrointestinale Tumore, Medizinische Klinik und

Poliklinik IV – Campus Innenstadt, Klinikum der Universität München, München,

Deutschland

Background: e foundation of European Reference Networks (ERN)

represents a major step to improve patient care and research for 24

rare and complex disease groups. As a whole, families with Hereditary

Tumor Syndromes (HTS) are a relevant target group and a paradigm for

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 251

successful preventive and precision oncology. However, it is suspected

that the majority of patients is still not diagnosed or experience a substan-

tial delay in diagnosis, which results in inadequate medical care. e ERN

GENTURIS aims to improve and standardize identication, genetic diag-

nostics, personalized prevention, and treatment of families with GENetic

TUmour RIsk Syndromes across Europe. So far, several specic guide-

lines, educational activities, and research projects have been developed.

Nevertheless, these achievements will only improve oncological care, if

they are implemented in national health care systems, which is regarded as

a major shortcoming also addressed by the EU JARDIN initiative.

Methods: erefore and in line with the EU requirements, a German

Reference Network for Hereditary Tumor Syndromes (GRN HTS) was

established in 2023 as one of 12 GRNs to date (www.se-atlas.de/drn).

Result: Currently, the GRN HTS consists of 11 centers, which are ERN

members and / or specialized B centers of Centers for Rare Diseases (A

centers). Overall, the network oers expertise for a broad spectrum of rare

HTS and involves patient representatives. e website is intended to act as

an information platform for all relevant areas and sources regarding clin-

ical and research aspects of HTS and is planned to go online in January

2024.

Discussion: Challenges are the recruitment of expert clinicians for specic

areas to complement the existing composition including the improvement

and extension of specialized outpatient clinics.

Disclosure Statement: e authors declare no conict of interest.

Conclusion: Future goals of the network include the implementation of registries

for rare HTS, training programs for organ-specic cancer centers, cross linking

with other initiatives in the eld, and ensuring the interoperability between local

and ERN data structures.

1122

PREVENT-TAKE-UP - individuelle Gesundheitskompetenz

stärken und fördern

Angelika Kestler1; Julian Schwab2; Yvonne Schmid1; Tanja Jaehnig3;

Michael Melzer4; Friedemann Zengerling4; Christian Bolenz4;

Stefan Lukac5; Wolfgang Janni5; Anne Barzel3; Hans Armin Kestler6;

Thomas Seuerlein1

1Universitätsklinikum Ulm, Klinik für Innere Medizin I, Ulm, Deutschland

2Universität UIm, Institut für medizinische Systembiologie, Ulm, Deutschland

3Universitätsklinikum Ulm, Institut für Allgemeinmedizin, Ulm, Deutschland

4Universitätsklinikum Ulm, Klinik für Urologie, Ulm, Deutschland

5Universitätsklinikum Ulm, Klinik für Frauenheilkunde, Ulm, Deutschland

6Universität UIm, Institut für medizinische Systembiologie, Ulm, Deutschland

Die Präventions- und Früherkennungs-App PREVENT-TAKE-UP soll

die Eigenverantwortlichkeit und individuelle Gesundheitskompetenz

von Patientinnen und Patienten stärken und einen Beitrag zur Förderung

der öentlichen Gesundheit leisten. Zielgruppe sind gesunde Personen,

die noch nicht an Vorsorgeuntersuchungen zu Brust-, Darm- oder

Prostatakrebs teilgenommen haben. Die App vermittelt Informationen

individualisiert an die Bedarfe und Bedürfnisse der Nutzer:innen vermit-

teln und eine informierte Entscheidungsndung unterstützen. Ziel ist die

Motivation zur Teilnahme an Vorsorge- und Früherkennungsmaßnahmen,

unter Berücksichtigung des eigenen Risikos, zu erhöhen und somit

Tumorerkrankungen in einem früheren Stadium mit höherer Aussicht

auf Heilung festzustellen.

Die App wurde multidisziplinär vom Institut für Medizinische

Systembiologie an der Universität Ulm in enger Kooperation mit

der Gastroenterologie, Gynäkologie, Urologie und dem Institut für

Allgemeinmedizin entwickelt.

In einer ersten Anwendungsstudie wurde die App von Patient:innen

in allgemeinmedizinischen Facharztpraxen getestet. Die Handhabung

wurde als einfach, die Fragen, wie auch die Informationen als relevant und

verständlich bewertet. Eine deutliche Mehrheit der Probanden würde das

durch die App empfohlene Arztgespräch nutzen. Männer sind dabei eher

häuger als Frauen unentschlossen, insgesamt zeigte sich die gemeinsame

Tendenz, dass die App motiviert, mehr an Vorsorge zu denken. Förderlich

hierfür sind die niederschwellige Verfügbarkeit (ohne Passwort/Account)

und die Anonymität, was zu einer breiten Nutzung und wahrheits-

gemäßen Beantwortung der Fragen führt und ggf. Hemmschwellen im

Vergleich zu einem persönlichen Erstgespräch mit dem Arzt/ der Ärztin

senkt.

Disclosure Statement: e authors declare no conict of interest.

990

An interactive cancer prevention awareness program for

adolescents provided by interdisciplinary experts from the

Comprehensive Cancer Center Munich

Irina Rupp1; Julian Holch1,2; Theres Fey1,10; Friederike Mumm2,3;

ClaudiaMück3; Anika Berling-Ernst4; Sabine Kesting5,6; Carolin Margraf7;

Christine Welker8; Hansjörg Baurecht8; Volker Heinemann1,9,10;

NicoleErickson1

1Comprehensive Cancer Center (CCC Munich LMU), Ludwig Maximilian

University (LMU) Hospital Munich, München, Deutschland

2Department of Medicine III, Ludwig Maximilian University (LMU) Hospital

Munich, München, Deutschland

3Interdisciplinary Center of Psycho-Oncology, Ludwig Maximilian University

(LMU) Hospital Munich, München, Deutschland

4Department I Internal Medicine, Center of Integrated Oncology, University

Hospital of Cologne, Köln, Deutschland

5Department Health and Sport Sciences, TUM School of Medicine and Health,

München, Deutschland

6Department Clinical Medicine, TUM School of Medicine and Health, München,

Deutschland

7Comprehensive Cancer Center München (CCC TUM), University Hospital rechts

der Isar, Technical University Munich, München, Deutschland

8Department of Epidemiology and Preventive Medicine, University of

Regensburg, Regensburg, Deutschland

9Comprehensive Cancer Center Munich (CCC Munich), München, Deutschland

10Bavarian Cancer Research Center (BZKF), Ludwig Maximilian University (LMU)

Hospital Munich, München, Deutschland

Background: Cancer prevention is a major goal of public health agencies

worldwide1. Information provision followed by behavior change advice

can increase the likelihood of habitual behavior2. erefore, we aimed to

increase awareness of the European Code Against Cancer (ECAC)3 and

promote lifestyle habit initiation among a representative sample of adoles-

cents in Bavaria, Germany.

Methods: is ongoing prospective interventional study comprises of

digitally based workshops, enhanced with a variety of active learning

components and culminating in a live interdisciplinary expert round.

ECAC awareness is assessed on hand questionnaires pre and post inter-

vention and again aer 3 months. Additionally, health behavior change is

measured using the transtheoretical model of change.

Results: In 2023, 8 schools from 4 dierent Bavarian districts completed

the workshop. To date, n = 645 adolescents from 3 dierent tiers of the

education system participated. 315 follow-up questionnaires have been

completed. 73 % specied that they found the information useful and 69 %

stated that the workshop provided practical implementation suggestions.

Discussion: Digitally based workshops enable experts to reach a wider

and more varied population. e participants demonstrate an initial

increased awareness of the ECAC and indicate that the program provides

practical implementation strategies.

Conclusion: Interactive health literacy studies focusing on cancer pre-

vention awareness are well received and a feasible method of increasing

awareness and implementation of the ECAC.

is study is funded by: Bavarian State Ministry of Health and Care

Indication of source:

1 World Health Organization (2023). Preventing cancer. https://www.who.int/

activities/preventing-cancer (14.12.2023)

2 Gardner, B., et. al. (2012). Making health habitual: the psychology of ‘habit-

formation’ and general practice. Br J Gen Practc, 62(605), 664–666.

3 International Agency For Research On Cancer (2016). European Code Against

Cancer. https://cancer-code-europe.iarc.fr/index.php/de/ (14.12.2023)

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts252

Psychooncology

1008

Screening in psycho-oncology – systematic assessment of the

psychosocial care needs of oncological and hematological

pateints in the outpatient setting

Michelle Entlicher1

1Landeskrankenhaus Feldkirch, Feldkirch, Österreich

Background: e diagnosis of cancer is oen accompanied by physical,

psychological and social problems. is does not only aect the qual-

ity of life of patients, but also their physical health and overall survival.

Adequate, needs-oriented psychosocial care contributes to the reduc-

tion of psychological distress in cancer patients and their relatives and

improves the quality of life. e aim of this study is to assess the need

and the utilization of psychosocial care of oncological and hematological

patients in an outpatient setting.

Methods: In a sample of 270 cancer outpatients (52.6% female), the

Distress ermometer, the GAD-7 and the PHQ-9 are used to assess rates

of distress, anxiety and depression. Furthermore the number of patients

who would utilize psychosocial support services were collected. Applying

the average marginal eect of the logit regression, the prevalence of the

utilizaiton of psychosocial support services was compared.

Result: One h of the sample would like an appointment with psycho-

social support services regarding psychological support. In contrast, only

around 7% of respondents wanted support in relation to care and nursing

or social work. e majority of these patients wanted a referral from the

hospital to the external psychosocial support service.

Discussion: According to the results of the analysis, dierent predictors

lead to the utilization of psychosocial support services in dierent cate-

gories. e desire for a support oer in one category is related to a desire

for support in another oered category. Further ndings indicate the rele-

vance of worries and nervousness, which have a positive inuence on the

use of psychosocial support services.

Conclusion: Patients suering from severe anxiety and symptoms

of depression were already linked to psychosocial support services.

Nevertheless, the ndings emphasize the importance of routine screening

techniques to evaluate psychosocial distress, as well as continued explo-

ration of the reasons for the need of support services for cancer patients.

Disclosure Statement: e authors declare no conict of interest.

1146

Potential and limitations of an inpatient therapeutic concept

for cancer patients with mental illnesses

Katja Schreyer1; Theresa Grimm1; Kristin Härtl2; Birgitt Marten-Mittag3;

Sabine Schäfer1

1Klinik Bad Trissl, Oberaudorf, Deutschland

2Fresenius Hochschule, München, Deutschland

3TUM, München, Deutschland

Background: Patients diagnosed with severe mental disorders linked to

their cancer diagnosis oen receive insucient psychotherapeutic sup-

port which can lead to an exarcerbation of psychological symptoms. Also,

a guideline-recommended cancer therapy can be impeded because of

psychological co-morbidities since simultaneous therapies oen prove to

be dicult. Due to this gap in healthcare provision a stationary therapy

program was developed and it‘s eectiveness evaluated within a long-term

study.

Methods: During the 6- to 12-weeks therapy program, patients partic-

ipated in multiprofessional therapies and, if needed, simultaneously

received their acute cancer therapy. e psychological and physical state

of the patients (n=144) was assessed by self-assessment questionnaires

(HADS-D, FBK-R23, EORTC-FA12 and others) at four measurment dates

(T1=start, T2=end, T3=3-months follow-up, T4=1-year follow-up).

Result: 91% of the patients had an aective disorder as their main diag-

nosis, 56% were diagnosed with gynecological cancer. 59% of patients

received cancer treatment. In the statistical comparisons a highly signicant

reduction in depression, anxiety, psychosocial stress experience and fatigue

symptoms was observed between T1 and T3 (all: p<0.001). e evaluation

of the T4-sample (response rate 57%) is in further analysis due to confound-

ing factors. Looking at referrers it becomes apparent that 74% of patients

were sent by psycho-oncologically trained sta, 17 % by physicians.

Discussion: e inpatient treatment leads to signicant improvement in

depression, anxiety, psychosocial stress and fatigue symptoms from the

start until 3 months aer discharge. Diculties arose in the evaluation of

the 1-year-follow-up.

Conclusion: It can be assumed, that the program can ll a gap in the

healthcare landscape. A future aim is to increase awareness of medical sta

and pay particular attention to patients with severe psychiatric disorders.

Disclosure Statement: e authors declare no conict of interest.

1009

Psychosocial aftercare needs of breast cancer patients in

Vorarlberg/Austria

Angelika Brüstle-Wild1

1Landeskrankenhaus Feldkirch, Feldkirch, Österreich

Background: e diagnosis of cancer can be described as a complex,

lengthy disease with numerous side eects. In addition, there are phys-

ical changes and psychological stress for patients and their social envi-

ronment. New treatment methods increase the risk of chronic diseases.

In 2020, 1 971 new invasive cases and 17 000 chronically ill people were

registered in Vorarlberg. is study examines the need for psychosocial

follow-up care for breast cancer patients aer acute care in the Feldkirch

speciality hospital, especially in the context of the current psycho-onco-

logical care situation in Vorarlberg. e need is examined empirically

using standardized questionnaires, primarily for breast cancer patients.

Methods: In semi-structured telephone interviews, sociodemographic

characteristics and quantitative data are collected. Established screening

instruments, such as FBK-R10 (Herschbach & Weis, 2010) and NCCN

Distress-ermometer (Mehnert et al., 2006) will be utilised and a partial

survey of patients, whose diagnosis was made in the years 2020 to 2022 in

the main hospital in Feldkirch will be carried out.

Result: e study, with 85 female subjects with an average age of 58 years,

identied clinically meaningful values on the Distress-ermometer Scale

and the problem list. More than a third of patients exceeded these values

on a physical and emotional level. e Spearman correlation revealed a

signicant positive association between the time since diagnosis and the

number of Distress-ermometer problems.

Discussion: ese ndings indicate that the psycho-oncological care sit-

uation in Vorarlberg should be strengthened and adapted to the specic

needs of patients, especially aer acute care, in order to improve the qual-

ity of life and well-being of oncological patients.

Conclusion: e results underline the need for improved information

transfer and optimized aercare, especially with regard to rehabilitation,

treatment options, psycho-oncological support and sensitive doctor-pa-

tient communication.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 253

Radiation

1084

Outcome of WHO Grade 2 and 3 meningiomas after

radiotherapy based on an integrated molecular-

morphological meningioma classication

Helen X. Hou1; Claire Delbridge2; Thomas Hielscher3; Benedikt Wiestler4,5;

Chiara Negwer6; Jan Peeken1; Christian Diehl1; Kai Borm1; Sandro Krieg6,7;

Kaywan A. Afthay6; Igor Yakushev8; Bernhard Meyer6;

StephanieCombs1,9,10; Felix Sahm11; Denise Bernhardt1,9

1Department of Radiation Oncology, Klinikum rechts der Isar, Technical

University of Munich (TUM), München, Deutschland

2Department of Neuropathology and Pathology, TU Munich, School of

Medicine, München, Deutschland

3Department of Biostatistics, German Cancer Research Center (DKFZ),

Heidelberg, Deutschland

4Department of Neuroradiology, Klinikum rechts der Isar, TU Munich, München,

Deutschland

5TranslaTUM, TU Munich, München, Deutschland

6Department of Neurosurgery, Klinikum rechts der Isar, TU Munich, München,

Deutschland

7Department of Neurosurgery, University Heidelberg, Heidelberg, Deutschland

8Department of Nuclear Medicine, Klinikum rechts der Isar, TU Munich,

München, Deutschland

9Institute of Radiation Medicine (IRM), Department of Radiation Sciences (DRS),

Neuherberg, Deutschland

10Deutsches Konsortium für Translationale Krebsforschung (DKTK), Partner Site

Munich, München, Deutschland

11Department of Neuropathology, Institute of Pathology, Ruprecht-Karls-

University Heidelberg, Heidelberg Germany; Clinical Cooperation Unit

Neuropathology, German Cancer Research Center (DKFZ), Heidelberg,

Deutschland

Background: Meningiomas (MNGs) occur in dierent histopathological

subtypes. e WHO grading system classies a subset as grade 2 and 3,

indicating a more aggressive course. Recent advances in risk stratication

introduces an integrated molecular-morphological score (IntS), oering

improved risk prediction over the traditional WHO classication. is

study aims to evaluate the prognostic utility of IntS in the context of adju-

vant radiotherapy (RT).

Methods: is retrospective study analyzed 55 patients with histolog-

ically diagnosed WHO grade 2 and 3 MNG treated with adjuvant RT.

Molecular analyses using Illumina 450k Human BeadChip and 850k EPIC

stratied patients into 3 risk groups (low, intermediate and high) using

an integrated model (IntS) that combines WHO grading, Copy Number

Variations (CNVs), and Methylation Families (MF).

Result: Aer 5 years a local failure-free survival (LFFS) rate of 50% in

MF-malignant MNG contrasts with an LFFS rate of over 80% in MF-benign

and MF-intermediate MNG. Aer 72 months early RT showed a potential

benet in MF-intermediate MNGs with a LFFS of 75% compared to an

LFFS of 25% with late RT. Additionally, a signicant correlation between

CNVs and LFFS was observed in the adjuvant setting.

Discussion: e integration of molecular and morphological criteria into

IntS highlighted distinct 5-year LFFS disparities across dierent risk cate-

gories. A pronounced therapeutic advantage of early adjuvant RT in terms

of LFFS has been shown in patients aicted with intermediate-grade

meningiomas (MFint), underscoring the potential of early adjuvant RT

in altering disease trajectory. Despite the promising direction, the small

cohort size calls for larger-scale studies to solidify the timing and extent

of RT benets.

Conclusion: e integration of DNA-methylation and CNV-proles into

the IntS unied risk score oer an enhanced prognostic dierentiation of

MNG patients. is approach shows a promising direction for guiding

the optimal timing of adjuvant RT, oering a path toward more tailored

treatment strategies for MNGs.

Disclosure Statement: e authors declare no conict of interest.

1125

Validation of scoring systems to predict overall survival

after stereotacic body radiation therapy (SBRT) for spinal

metastases

Maria Waltenberger1,2; Christian Strick1; Marco M.E. Vogel1;

Stephanie E. Combs1,2,3

1Department of Radiation Oncology, Klinikum rechts der Isar, Technical

University of Munich (TUM), Munich, Deutschland

2German Cancer Consortium (DKTK), partner site Munich, a partnership

between DKFZ and University Hospital Klinikum rechts der Isar, Germany,

Munich, Deutschland

3Institute of Radiation Medicine (IRM), Helmholtz Zentrum, Neuherberg,

Deutschland

Background: Spinal metastases (SM) are increasingly treated with SBRT,

both in the context of oligometastatic disease (OMD) and palliation.

ere exist two scoring systems (SS) for overall survival (OS) prediction

aer spinal SBRT: Kowalchuck et al. developed a score (KS) for OMD

patients (pat) receiving brain, lung or spinal SBRT (2023; validated exter-

nally). e PRISM score assesses OS aer spinal SBRT (Tang et al., 2015;

validated internally). Further validation analyses are desirable prior to

routine use of the SS.

Methods: N=79 pat with n=96 SM received SBRT between 2010 and 2022

at our institution and were included in the validation analyses. For KS,

only OMD pat (= max. 5 metastases) were analyzed. Scores were calcu-

lated for each pat. OS was assessed with Kaplan-Meier method. e prog-

nostic relevance of the SS was tested using log-rank test.

Result: N=74 pat received SBRT for OMD and n=5 pat in palliative

intent. Most common entities were prostate (n=37) and breast (n=15)

cancer, NSCLC (n=7), melanoma (n=6), head/neck cancer and sarcoma

(n=4 each). Most pat were male (n=53), had good ECOG (n=57), bone

metastases only (n=63) and no previous local therapy (n=76). Time from

diagnosis to SM was mostly <5 years (n=52). SBRT was mainly delivered

with 5 x 5/8 Gy (n=40). Median time from SBRT to last follow up/death

(known for n=21 pat) was 22 months (m; IQR 13.5-37). Median OS was

64 m (95% CI 30.03-91.97) for all and 83 m (95% CI 48.04-121.86) for

OMD pat. For KS, pat were assigned to groups (G) 0 - 3 that showed sig-

nicant OS dierences (p=0.004). For PRISM, pat were stratied into G

1 - 4 with signicant OS dierences (p<0.001) as well.

Discussion: With a high proportion of OMD pat with good ECOG, our

cohort did not represent all G of the respective SS. e relatively low num-

ber of pat and deaths are limiting as well. Nevertheless, we were able to

externally conrm the predictive relevance of the two SS.

Conclusion: Our data support the assumption that KS and PRISM are

valid tools for OS prediction aer spinal SBRT. Conrmatory analyses in

a larger and more heterogenous cohort are warranted.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts254

1070

C-reactive protein (CRP) is the most robust laboratory value

associated with prognosis in patients with inoperable stage

III non-small cell lung cancer (NSCLC) treated with denitive

radiochemotherapy (RCT)

Cedric Richlitzki1,2; Marcel Wiesweg3,4; Martin Metzenmacher3,4;

NikaGuberina2; Thomas Gauler2; Hubertus Hautzel5,6; WilfriedEberhardt3,4;

Kaid Darwiche7; Dirk Theegarten8; Martin Schuler3,4,6; Martin Stuschke2;

Maja Guberina2,9

1Department of Radiotherapy and Radiation Oncology, University Hospital

München, LMU, München, Deutschland

2Department of Radiotherapy, West German Cancer Center, University Hospital

Essen, Essen, Deutschland

3Department of Medical Oncology, West German Cancer Center, University

Hospital Essen, Essen, Deutschland

4Division of Thoracic Oncology, University Medicine Essen – Ruhrlandklinik,

Essen, Deutschland

5Department of Nuclear Medicine, University Hospital Essen, West German

Cancer Center, University Duisburg-Essen, Essen, Deutschland

6German Cancer Consortium (DKTK), Partner Site University Hospital Essen,

Essen, Deutschland

7Department of Pulmonary Medicine, Section of Interventional Pneumology,

University Medicine Essen – Ruhrlandklinik, West German Lung Transplantation

Center, Essen, Deutschland

8Institute of Pathology, University Hospital Essen, Essen, Deutschland

9German Cancer Consortium (DKTK), Partner Site University Hospital Essen,

Essen, Deutschland

Background: Aim was to gather data on blood parameters (BP), their

prevalence, and impact on overall survival (OS). Seven BP from 160

patients were analyzed at ve time points during the therapy.

Methods: OS was dened from start of radiotherapy (RT) to death.

Kaplan Meier analyses and the Log Rank test were employed for OS anal-

yses. Cox regression analysis was utilized to examine factors inuencing

OS. BP with p < 0.05 underwent multivariate analyses with clinical cofac-

tors. Deviations from the Proportional Hazards assumption were assessed

using the Kolmogorov Type Supremum Test. Cross validation was con-

ducted to estimate predictions for similar patient populations using the

Leave One Out Cross Validation (LOOCV) method. Prognostic models

were constructed on training datasets and then applied to the omitted

dataset to classify high and low risk groups split at the median. In an iter-

ative process, models with clinical parameters (CP) were compared with

those incorporating additional BP. BP were classied as continuous vari-

ables or according to the median. Exploratory analyses were performed

with cut o values deemed relevant in prior studies.

Result: Elevated CRP value as a continuous variable (HR 1.099 (1.038 –

1.164) p=0.0012) as well as aer a data split at the median (HR 2.214

(1.388 – 3.531) p=0.0008) in the last RT week emerges as a prognostic

factor for OS. In the multivariate analysis of BP and key CP, the CRP value

remained signicant (HR 1,105 (1,040 - 1,173) p ,0012). Even aer per-

forming LOOCV of the CRP value together with CP, a p-value of 0.0177

was obtained. us, the CRP value at the end of RT has successfully passed

the critical test of cross validation.

Discussion: Elevated BP do provide inuence on clinical treatment deci-

sions regarding RCT. Among the analyzed BP, the CRP value at the end of

RT was the most robust BP associated with OS.

Conclusion: e data presented on the CRP value may show that, in the

course of therapy, inammation markers should gain importance and

attention, especially with the increasing importance of immunotherapy as

a consolidation therapy for NSCLC.

Disclosure Statement: e authors declare no conict of interest.

Rehabilitation, Sports Medicine, and

Long-term Burden in Cancer Survivors

1089

Sport as tool for symptom reduction in patients with systemic

mastocytosis - is it feasible? - Results of a multicenter

survey of the East German Study Group for Hematology and

Oncology (OSHO #97)

Theresa Koch1; Jens Panse2,3; Deborah Katharina Christen2,3;

SusannSchulze4,5; Dietrich Kämpfe6; Nicole Hegmann7;

ChristianJunghanß1; Sabine Felser1

1Department of Medicine Clinic III, Hematology, Oncology, Palliative Medicine,

University Medical Center Rostock, Rostock, Deutschland

2Department of Oncology, Hematology, Hemostaseology and Stem Cell

Transplantation, University Hospital RWTH Aachen, Aachen, Deutschland

3Center for Integrated Oncology (CIO), Aachen, Bonn, Cologne, Düsseldorf,

Deutschland

4Krukenberg Cancer Center Halle (Saale), University Hospital Halle, Halle (Saale),

Deutschland

5Department of Medicine Clinic II, Hematology, Oncology, Palliative Medicine,

Carl-von- Basedow-Klinikum, Merseburg, Deutschland

6Hematology and Oncology Practice, Lüdenscheid, Deutschland

7Mastocytosis self-help network e.V., Köln, Deutschland

Background: Systemic mastocytosis (SM) is characterized accumulation

of clonal mast cells within various organs with dierent degrees of organ

involvement +/- dysfunction. e release of mast cell mediators can lead

to a plethora of symptoms including allergic reactions and can be trig-

gered by various factors such as physical exertion. Whether sports can

help to reduce SM symptom burden - as described for other clonal (neo-

plastic) diseases - has yet not been investigated.

Methods: A multicenter SM patient (pts; ≥18 years) survey was conducted

between 03 and 12/2022 in cooperation with the Mastocytosis Self-Help

Network (DRKS 00023698). Recorded were: demographics, clinical data,

symptom burden, quality of life (QoL), triggers and fears in connection

with sports, the level of information on “physical activity in SM” and

-using the Transtheoretical Model of Behavior Change- the motivation

for regular exercise. Sporty active and inactive pts were compared.

Result: e analysis included 159 questionnaires (134 (84%) female, mean

age 51 ± 11 years). No group dierences with regard to demographic and

clinical data were observed. Sporty active pts (n = 60, 38%) showed lower

symptom burden and better QoL compared to inactive pts (n = 99, 62%;

p = 0.018). Within the sport inactive pts, light sporting activities were

signicantly more likely to trigger symptoms compared to the active pts

(30% vs. 17%), but 19% stated that sport was not a trigger and 21% were

unaware. More inactive than active pts were afraid of allergic reactions in

the context of sport (59% vs. 40%, p = 0.026). Overall, 66% of pts stated

that they were insuciently informed about the topic “physical activity

in SM”.

Discussion: e majority of pts with SM are sport inactive. e reasons

for this are fear of symptoms, especially allergic reactions, lack of motiva-

tion and possibly unawareness of the benecial eects of sport. e data

suggest that sport is feasible for many pts with SM and may reduce symp-

tom burden.

Conclusion: Intervention studies are justied and necessary to investigate

the eects of sport on SM symptom burden.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 255

1081

Eects of one-week skiing intervention on dynamic balance

and gait ability in brain tumor patients and their relatives

Nora Hansel1; Jule Rösener2; Johanna Jost3; Ralf Brandt3; Eric Eils2;

Dorothee Wiewrodt3

1Department of Neurosurgery, Münster University Hospital, Münster,

Deutschland

2Institute of Sport and Exercise Science, University Muenster, Münster,

Deutschland

1Department of Neurosurgery, Münster University Hospital, Münster,

Deutschland

Background: Brain tumor diagnosis deeply impact patients’ and their

relatives’ lives. Exercise interventions show potential to improve tness

levels and enhancing quality of life. Skiing, renowned for its combination

of endurance, strength, and balance provides a unique opportunity to pro-

mote stability. is study aims to assess eects of a 1-week skiing program

enhancing balance, gait ability, and improving quality of life (QoL).

Methods: is study is a non-randomized pre-/post trial for patients

with primary brain tumor (PBT) and their relatives. All subjects partic-

ipated in a 1-week ski excursion involving 4 hours daily either downhill

or cross-country skiing. QoL assessments occurred before (t1), during

(t2), aer intervention (t3). Y-Balance Test (YBT) and 6 Min Walk Test

(6MWT) were run at t1 and t3. Non-parametric statistics were used for

data analysis (P < 0.05).

Result: 12 subjects (4 male) aged of 48 ± 15.2 were involved. Including

7 patients, 6 with supra- and one with infracerebellar tumors (WHO 4:

71.4%, WHO 2: 28.6%). No signicant dierences were found between

male/female or patients/relatives. Aer intervention, YBT revealed a sig-

nicant increase in maximum range by 5.7-8.8% (p=0.028) (patients 5.1-

11.3%, relatives 5.6-8.2%). 85.7% of patients and 80.0% of relatives falling

below composite score of 94. In the 6MWT, median distance increased

58m (patients 590m to 638m, relatives 643m to 719m), and positively cor-

related with the balance increase (r=0.68, p=0.042). Anxiety and depres-

sive symptoms decreased, and self-ecacy increased in terms of QoL.

Discussion: e YBT results show dierences between le/right side,

mainly in anterior direction. is might be related to brain tumor loca-

tion. On average, patients showed greater improvements in YBT and

6MWT as their relatives.

Conclusion: A 1-week skiing program enhances balance, increases gait

ability and augments QoL comparable for PBT and their relatives. Using

YBT and 6MWT in PBT represents an innovative approach to capture gait

ability. Still, the limited sample size conducted further validation.

Disclosure Statement: e authors declare no conict of interest.

975

Factors inuencing physical activity in children and

adolescents during and after cancer: A systematic review.

Laura Kappelmann1; Miriam Götte2; Arno Krombholz3; Britta Fischer1

1Christian-Albrechts-Universität zu Kiel, Institut für Sportwissenschaft, Kiel,

Deutschland

2Westdeutsches Tumorzentrum Essen, Universitätsklinikum Essen, Essen,

Deutschland

3Ruhr-Universität-Bochum, Bochum, Deutschland

Background: Research has shown that childhood cancer survivors (CCS)

do not achieve the minimum recommended level of PA (1). erefore,

the aim of this review (2) was to identify the social, personal and con-

textual factors that inuence PA in CCS. It is hoped that the ndings can

optimise care in the future, recognising the need for multidisciplinary

collaboration.

Methods: SPORTDiscus, Cochrane, Web of Science, PubMed and FIS

Education electronic database were systematically searched.Result: e 13

out of 1849 included studies show the importance of social support, which

can fundamentally inuence PA and motivate to engage in PA. ere are

dierences according to treatment status, for example, parents are more

likely to prohibit PA in the active phase. Inhibiting personal factors are

concerns about infections or the general state of health. Another import-

ant contextual factor is whether a special exercise programme for CCS is

oered in the hospital or the spatial conditions.Discussion: Parents are

generally important supporters of PA. At the same time, concerns are

expressed that are not based on concrete facts, so inadequate information

could be discussed as a cause. Contextual factors inuence PA depending

on the setting and must always be considered in context and depending

on the treatment status.

Conclusion: e most important factor is personal health status. In addi-

tion, social and contextual factors can be identied as inhibiting and pro-

moting factors. It becomes clear that an interdisciplinary understanding is

necessary to increase the PA and to optimize care structures.

Indication of source:

1 Roussenq SC, Hintz LG, Rafael AD, et al. Level of physical activity and sedentary

behavior in children and adolescents diagnosed with cancer: a systematic review.

Int J Health Sci. 2022;16(3):54–63.

2 Kappelmann L, Götte M, Krombholz A, Hüter J, Fischer B.. Factors at

Inuence Physical Activity Behavior in Children and Adolescents During and

Aer Cancer Treatment: A Qualitative Systematic Review of the Literature.

Pediatr Exerc Sci. 2023 Oct 27:1-9.

Disclosure Statement: e authors declare no conict of interest.

994

The physical activity level in long-term survivors with

gynecological cancer - A preliminary analysis of the

“Survivorship Clinic for Long-term Survivors with

Gynecologic Cancer”

Johanna Porst1; Verena Krell1; Franziska Greiß1; Hannah Woopen2;

JalidSehouli2; Stephanie Roll3; Julia Alexandra Steinle2; Joana Baum2;

Petra Hühnchen4; Katharina Layer4; Kirsten Wittke5;

CarmenScheibenbogen5; Adak Pirmorady6; Matthias Rose6; Nicole Balint2;

Frank Edelmann7; Knut Mai8; Lukas Maurer8; Sandra Krabbe8;

MaxiNeubauer8; Eva Siebenhüner8; Reinhold Kreutz9; Engi Algharably9;

Fabian Maximilian Meinert10; Cindy Stoklossa11; Elisabeth Harmuth11;

Thomas Reinhold3; Stefan N. Willich3; Bernd Wolfarth1

1Abteilung Sportmedizin der Charité - Universitätsmedizin Berlin, Berlin,

Deutschland

2Klinik für Gynäkologie mit Zentrum für onkologische Chirurgie der Charité –

Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Deutschland

3Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie der

Charité − Universitätsmedizin Berlin, Charité, Campus Mitte, Berlin, Deutschland

4Klinik für Neurologie der Charité − Universitätsmedizin Berlin, Charité -

Campus Mitte und Campus Virchow Klinikum, Berlin, Deutschland

5Fatigue-Zentrum, Charité – Universitätsmedizin Berlin, Campus Virchow-

Klinikum, Berlin, Deutschland

6Medizinische Klinik mit Schwerpunkt für Psychosomatik der Charité −

Universitätsmedizin Berlin, Campus Mitte, Berlin, Deutschland

7Medizinische Klinik mit Schwerpunkt Kardiologie der Charité –

Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Deutschland

8Medizinische Klinik für Endokrinologie, Diabetes und Stowechselmedizin der

Charité − Universitätsmedizin Berlin, Charité, Campus Virchow-Klinikum, Berlin,

Deutschland

9Institut für Klinische Pharmakologie und Toxikologie derCharité −

Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Deutschland

10Institut für Klinische Pharmakologie und Toxikologie der Charité −

Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Deutschland

11Sozialdienst der Charité – Universitätsmedizin Berlin, Campus Virchow-

Klinikum, Berlin, Deutschland

Background: e study ‘Survivorship Clinic for long-term survivors (LTS)

with gynecological cancer’, initiated by the Department of Gynecology,

Charité – Universitätsmedizin Berlin aims to promote quality of life in LTS.

A healthy and active lifestyle can reduce therapy-associated long-term side

eects [1]. erefore, sports medical consultations are part of this study.

Methods: A preliminary analysis of baseline data of the study’s interven-

tion group, conducted at the Department of Sports medicine, Charité

Berlin. Main inclusion criterion was the diagnosis of gynecological cancer

at least ve years ago. A detailed sports medical anamnesis was imple-

mented to depict every patient’s weekly physical activity (WPA) in relation

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts256

to the ocial guidelines [1]. ECG, blood pressure and pulmonary exercise

testing (CPET) indicated patients’ medical tness.

Result: In total, 163 of 192 (85 %) LTS attended a sports medical baseline

visit, 29 (15 %) did not attend due to medical risk factors or non-com-

pliance. Nine of 163 (6 %) could not perform the CPET due to medical

risks factors. Subsequently, 122 of 154 (79 %) were tested and certied as

medical t, 25 (16 %) as having limited tness and seven (5 %) were unt

to do sports. WPA ranged from zero to 23 hours (Mean=3.5, SD=4.3).

Overall, 46 of 163 LTS (28 %) were interviewed and reported no WPA at

all, 42 (26 %) engaged in less than 2.5 hours, while 75 (46 %) reported

more than 2.5 hours of WPA.

Discussion: Although, 79 % and 16 % were certied medical and limited

t, respectively, 54% did not meet the guidelines for WPA, 28% even with

no WPA at all. Baseline history and diagnostics revealed a great disparity

between the recommended ocial WPA guidelines and the actual WPA

levels in LTS.

Conclusion: ere is a great potential for improving WPA in LTS.

erefore, interventions to promote this behaviour are highly required.

Indication of Source:

1 Campbell, Kristin L., et al. “Exercise guidelines for cancer survivors: consensus

statement from international multidisciplinary roundtable.” Medicine and

science in sports and exercise 51.11 (2019): 2375.

Disclosure Statement: e authors declare no conict of interest.

1037

Communication between oncologists and general

practitioners in long-term care for cancer survivors

Sandra Salm1; Astrid Klein2; Meike Gerber3; Jennifer Engler1;

TeresaHalbsguth4; Karola Mergenthal1; Karen Voigt2; Corina Güthlin1

1Institut für Allgemeinmedizin, Goethe-Universität Frankfurt, Frankfurt am

Main, Deutschland

2Technische Universität Dresden, Universitätsklinikum Carl Gustav Carus, Bereich

Allgemeinmedizin / Medizinische Klinik und Poliklinik III, Dresden, Deutschland

3Technische Universität Dresden, Institut für Geschichte der Medizin, Dresden,

Deutschland

4Universitäres Centrum für Tumorerkrankungen Frankfurt, Sprechstunde

Langzeitnachsorge nach Krebs, Frankfurt am Main, Deutschland

Background: Following the completion of the ve-year cancer follow-up,

long-term monitoring usually shis to general practice. Oncologists encoun-

ter the challenge of determining the essential information to furnish to gen-

eral practitioners (GPs) to ensure adequate treatment of long-term eects

and early recognition of late eects. is study aims to explore the necessary

content and structure of reports to GPs regarding long-term cancer care.

Methods: Fourteen GPs were interviewed to gauge their perspectives on

the content and structure of hypothetical reports from long-term cancer

consultations. An inductive summary was employed to analyze the col-

lected data. Additionally, a think-aloud interview was conducted with an

oncologist engaged in long-term consultations to understand the process

of formulating reports for GPs.

Result: In the eld of oncology, emphasis is placed on presenting a clear con-

nection between patients’ complaints/symptoms, potential long-term/late

eects, and subsequent care provision. Consequently, oncologists’ reports

comprise continuous text. GPs expressed the need for tailored recommenda-

tions for long-term cancer care within primary care and a desire to compre-

hend the rationale behind suggested care procedures. ey favored a concise

format utilizing bullet points and tables over complex text sections.

Discussion: Divergent preferences between oncologists (as report trans-

mitters) and GPs (as recipients) concerning report structure are evident.

Oncologists prioritize complete traceability, whereas GPs seek rapid infor-

mation assimilation through succinct overviews.

Conclusion: e diering preferences observed in this study will be delib-

erated with interview participants in a workshop setting. e aim is to

generate mutual recommendations for preparing reports for GPs on long-

term cancer care.

Disclosure Statement: e authors declare no conict of interest.

1132

The additional therapeutic benet of physical activity in

a patient with BRCA1+ ovarian cancer: a case report with

11years follow-up

Anika Berling-Ernst1; Martin Halle2; Claudia Gross2; Melanie Heitkamp2;

Caterina Fiorentini2

1Klinik I für Innere Medizin, Universitätsklinikum Köln, Köln, Deutschland

2Präventive Sportmedizin und Sportkardiologie, Medizinische Fakultät, Klinikum

rechts der Isar, Universitätsklinikum der Technischen Universität München,

München, Deutschland

Background: A BRCA1 germline mutation is associated with an increased

lifelong risk of developing breast and/or ovarian cancer. However, the

penetrance varies individually, suggesting that lifestyle, e.g. physical activ-

ity (PA), may also inuence the occurrence and progression of cancer in

BRCA1 mutation carriers. Observational studies indicate that it may also

be possible to extend the disease-free survival time through PA. erefore,

maintaining cardiorespiratory tness (CRF) through PA is an important

component of oncological patient care during and aer tumor therapy.

Methods: A recreational athlete with a conrmed BRCA1 germline muta-

tion in her early 50s (baseline 2011: body mass index 19 kg/m2; VO2peak

27.2 ml/min/kg, 117% of normal value), diagnosed with poorly dierenti-

ated ovarian cancer (OC), underwent several tumor therapies and a pro-

phylactic bilateral mastectomy from 2011-2023. e postoperative tumor

classication was: pT3c; pN1(1/46), L0, V0, G3 stage IIIC according to

FIGO and UICC. e patient was continuously monitored by sports medi-

cine during the tumor therapy. CRF measured by VO2peak was documented

annually by using cardiopulmonary exercise testing (CPET) (n=11) from

2011-2023. In addition, VO2peak was recorded one week before, during and

aer chemotherapy administration (CTX) in 2022.

Results: Over the entire period, the patient was primarily physically active

with endurance sports in the form of cycling and running (at least 25-30

MET-h/week). In 2013, the patient completed a marathon and achieved

a VO2peak of 35.4 ml/min/kg (152% of norm value) in 2014. By 2022, the

VO2peak increased from one week before CTX (20.5 ml/min/kg 86% of

norm value) to the day of CTX (23.1 ml/min/kg 100% of norm value) and

was maintained above baseline one-week post CTX (21.5 ml/min/kg 89%

of norm value).

Discussion: CPET was suitable during and aer CTX as a control diag-

nostic to individualize and maintain the training program. In this case

study it could be shown that PA was feasible in every therapy phase and

could even be performed on the day of CTX.

Disclosure Statement: e authors declare the following: Mitarbeit an der S3 LL

zur Bewegungstherapie in der Onkologie

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 257

Sarcoma

1120

A rened cell culture method for characterization of Ewing

Sarcoma cell line phenotype and FET::ETS activity

A. Katharina Ceranski1,2,3; Martha J. Carreño Gonzalez1,2,3;

AnnaC.Ehlers1,2,3; Zuzanna Kolodynska1,2,3; Philipp Poeller4,5;

AlmutSchulze4; Shunya Ohmura1,2,3; Florencia Cidre-Aranaz1,2,3;

Thomas G. P. Grünewald1,2,3,6

1Hopp-Children’s Cancer Center (KiTZ), Heidelberg, Deutschland

2Division of Translational Pediatric Sarcoma Research, German Cancer Research

Center (DKFZ), German Cancer Consortium (DKTK), Heidelberg, Deutschland

3National Center for Tumor Diseases (NCT), NCT Heidelberg, a partnership

between DKFZ and Heidelberg University Hospital, Heidelberg, Deutschland

4Division of Tumor Metabolism and Microenvironment, German Cancer

Research Center (DKFZ) and DKFZ-ZMBH Alliance, Heidelberg, Deutschland

5Faculty of Biosciences, Heidelberg University, Heidelberg, Deutschland

6Institute of Pathology, Heidelberg University Hospital, Heidelberg, Deutschland

Background: Ewing sarcoma (EwS) is an aggressive pediatric bone and

so tissue cancer. It is genetically characterized by FET::ETS fusion onco-

genes, mostly EWSR1::FLI1, encoding aberrant transcription factors. A

substantial part of EwS research relies on in vitro models. Yet, concerns

exist about their limited capability to adequately reect physiological

conditions. In this study we aim to improve EwS cell culture methods to

mimic physiological conditions more closely. In the advanced setup, we

characterize the phenotype of EwS cell lines and transcriptional activity of

FET::ETS fusion oncogenes.

Methods: Advanced medium composition and 3D culture technique

were used to culture EwS cell lines. We characterized the phenotype and

FET::ETS activity with dierent in vitro proliferation and viability assays,

RT-qPCR, transcriptome proling (Aymetrix Clariom D microarray)

and bioinformatic analyses.

Results: Principal Component Analysis (PCA) of transcriptome proling

data of EwS cell lines cultured in the standard versus rened setup reveals

sample clustering according to culture condition and cell line. Gene Set

Enrichment Analysis (fGSEA) of EwS cells grown in the rened cell cul-

ture shows enrichment for established EWSR1:FLI1 signatures as well as

pathways related to hypoxia, glycolysis, and cell signaling.

Discussion: EWSR1::FLI1 activity in the rened cell culture shows con-

sistency with established EWSR1::FLI1 signatures in standard conditions.

Yet, approx. 50% of dierentially expressed genes (DEGs) depending on

EWSR1::FLI1 activity in physiological cell culture are not shared with

DEGs recovered from EWSR1::FLI1 activity in standard cell culture.

is emphasizes the importance of rening cell culture methods for EwS

research.

Conclusion: Our rened cell culture setup is a suitable model for EwS

in vitro studies as it preserves EwS cell characteristics and better mim-

ics biological features of the tumor microenvironment, such as hypoxia.

Moreover, the technique is feasible, cost-eective and more ani-

mal-friendly than standard methods.

Disclosure Statement: e authors declare no conict of interest.

Skin Cancer including Melanoma

1130

Improved Melanoma Survival in Germany: A Registry-Based

Time Series Study

Laura Schumann1; Nora Eisemann1; Alexander Katalinic1; Hannah Baltus1;

Louisa Labohm1; Klaus Kraywinkel2

1Institut für Sozialmedizin und Epidemiologie, Lübeck, Deutschland

2Zentrum für Krebsregisterdaten, Robert-Koch-Institut, Berlin, Deutschland

Background: Since 2011, new treatment options specically for prog-

nostically unfavorable cutaneous melanoma are available, such as immu-

notherapies and targeted agents. Randomized controlled trials report

improvements in survival, but it is unclear if benecial eects are also

appearing on the population-level.

Methods: All patients with melanoma diagnosis (ICD10: C43) in 2000-19

were included from population-based cancer registries. Five-year relative

survival (5YRS) was calculated for four ve-year periods (2000-04, 2005-

09, 2010-14, 2015-19). To correct for temporal and regional dierences in

sex, age groups and UICC stage, standardization/stratication was per-

formed. Regression modelling was used to capture signicance (p<0.05)

of an expected time trend.

Result: We included 301,486 patients. e 5YRS improved from 93%

(2000-04) to 95% (2015-19) and in almost all investigated subgroups.

e largest increases occurred from 2010-14 to 2015-19, and there in

advanced melanoma, with 5YRS for stage UICC IV melanoma increasing

from 31% to 36% (relative dierence +16%). e overall survival trend

over all time periods showed a signicant improvement.

Discussion: In addition to new targeted therapies, other factors in care

and treatment, such as changes in registration or the introduction of

the national skin screening program, could have an impact on survival.

However, our analyses attempted to correct for these inuences, for exam-

ple by stage and age standardization or stage-specic analyses.

Conclusion: Over the past 20 years, survival of melanoma patients

improved signicantly. e largest improvements were seen for advanced

tumor stages from 2010-14 to 2015-19. is development strongly sup-

ports that the positive eects of new therapies that were observed in RCTs

are also evident population-based aer their approval.

Disclosure Statement: e authors declare no conict of interest.

Supportive Care

1090

Delayed chemotherapy-induced nausea – Occurrence and

corelates in a multi-center study in adult oncology patients in

clinical practice (CINrate)

Antje Koller1; Ramona Engst1; Agnes Glaus2; Rahel Hein3; Ulrike Mößner4;

Stefan Ott5; Andrea Kobleder5

1OST Eastern Switzerland University of Applied Sciences, Institute for Nursing

Sciences, St. Gallen, Schweiz

2Stiftung Onkologische Fortbildung und Kongresse (SONK), St. Gallen, Schweiz

3Spital Thurgau AG, Münsterlingen Cantonal Hospital, Oncology department,

Münsterlingen, Schweiz

4University Freiburg, Department of Internal Medicine, Haematology, oncology

and stem cell transplantation, gastroenterology, Freiburg, Deutschland

5OST Eastern Switzerland University of Applied Sciences, Department of

Economics, St. Gallen, Schweiz

Purpose: Nausea and vomiting negatively impact patients’ quality of life

and antitumor therapy. Delayed chemotherapy-induced nausea (dCIN),

especially with low (LEC) and minimally emetogenic systemic antitu-

moral therapy (MinEC), is oen underestimated in clinical practice. is

study aims to assess dCIN occurrence, focusing on LEC and MinEC, and

describe associated antiemetic therapy and patient characteristics.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts258

Methods: In a multicenter cross-sectional study, patients rated dCIN on

a VAS 0-100 in a daily diary. e primary endpoint was dCIN in LEC and

MinEC. Secondary endpoints were acute CIN (aCIN) and chemothera-

py-induced vomiting (CIV). e relationship between dCIN and sec-

ondary endpoints was determined with a multi-variate regression model

under control of the named risk factors.

Result: In three centers, 2 in Switzerland and 1 in Southern Germany,

172 patients were recruited. Of these, 31 (18%) had MinEC, 65 (38%)

had LEC, 61 (36%) had moderately and 15 (9%) had highly emetogenic

antitumoral therapy. Occurrence of dCIN in LEC was 19% (12 of 65;

95%CI 9.2/27.7) with a mean intensity of 31.5 (ranging from 12.5 to 60.8).

Occurrence of dCIN in MinEC was 3% (1 of 31; 95%CI 0/9.7) with a mean

intensity of 76.0. Overall, 31 patients (18%) experienced CIN with 17

patients (10%) experiencing signicant CIN (VAS>2.5). Only 3 patients

(2%) experienced vomiting. Risk factors for dCIN were determined in a

regression model.

Discussion & conclusion: In clinical settings, vomiting is gener-

ally well-managed, but CIN and especially dCIN still pose challenges.

Although occurrence rates have signicantly decreased, more data is

required to eectively manage dCIN in the remaining patients. Known

risk factors and current antiemetic regimens oer only limited support for

prevention. Clinicians must ensure not to miss out on those patients who

still suer from signicant CIN.

Disclosure Statement: e authors declare no conict of interest.

1148

The association between sleep problems and general quality

of life in cancer patients and in the general population

Dirk Hofmeister1,1; Anja Mehnert-Theuerkauf1; Thomas Schulte2;

AndreasHinz1

1Department of Medical Psychology and Medical Sociology, Leipzig University,

Leipzig, Deutschland

2Rehabilitation Clinic Bad Oexen, Bad Oeynhausen, Bad Oeynhausen,

Deutschland

Background: Sleep problems are frequent in cancer patients. Sleep quality

is associated with general quality of life (QoL). e aims of this study were

to analyze the relationship between sleep problems and other components

of QoL in more detail and to investigate sex and age dierences in sleep

quality in cancer patients in comparison with the general population.

Methods: is study comprised one general population sample (n = 4,476)

and eight samples with cancer patients (n between 323 and 4,020). Sleep

Quality was measured using the QoL questionnaire EORTC QLQ-C30.

Results: All of the cancer patient groups reported more sleep problems

than the general population. Sleep problems were associated with all facets

of QoL. e highest associations were found in cancer patients for fatigue

(r = 0.52) and emotional functioning (r = −0.47). e association between

sleep quality and general QoL was lower in the cancer samples (r = −0.37)

than in the general population (r = −0.46). e correlations between sleep

and global QoL are negative for all subgroups. is indicates a decreasing

quality of life with increasing sleep problems. Female and younger cancer

patients reported markedly more sleep problems than male (d = 0.45) and

older patients did (d = −0.17).

Discussion: e present study contributes to clarifying the magnitude

and role of sleep problems in the context of QoL. It underlines that sleep

problems are severe in cancer patients. e psychological QoL dimen-

sions are more strongly correlated with sleep problems than are the more

physical components.

Conclusion: e results o he study gives oncologists and other health

care providers information concerning groups with specic needs, espe-

cially females and young cancer patients.

Indication of source: Hofmeister, D., Schulte, T., Mehnert-euerkauf, A., Geue,

K., Zenger, M., Esser, P., Götze, H., Hinz, A. (2022). e association between sleep

problems and general quality of life in cancer patients and in the general popula-

tion. Front Psychol, 13, 960029.

Disclosure Statement: e authors declare no conict of interest.

1147

Evaluation of one-year data of a sports medical outpatient

clinic for cancer patients

Jessica Kuhn1; Verena Krell1; Franziska Greiß1; Johanna Porst1;

Tilman J. Pulst Caliman1; Bernd Wolfarth1

1Abt. Sportmedizin, Charité - Universitätsmedizin, Berlin, Deutschland

Background: In recent years, many studies have shown the benets of

exercise during and aer cancer treatment regarding therapy-associated

side eects. erefore, we established a sports medical outpatient clinic

for cancer patients (SOC) at the department of sports medicine, Charité –

Universitätsmedizin Berlin to provide individual exercise advice.

Methods: e SOC includes an oncologically focused anamnesis, a brief

check-up for evaluating the sports capability, individual exercise advices,

and, if needed, a referral to a training institution. We used data of SOC

from Aug 2022-Nov 2023 for descriptive analysis.

Result: 237 cancer patients (mainly breast cancer patients: n=133, 56.1%)

used the SOC during or aer cancer treatment (median=12 months,

range=0-478 months since cancer diagnosis). At the time of SOC, weekly

moderate and vigorous physical activity minutes ranged from 0 to 1500

(M=281, SD=252). 217 patients (91.6%) were referred to a training insti-

tution for a supervised resistance training.

Discussion: Although it appears that most of the patients meet the rec-

ommendations of 150 min of moderate or 75 min of vigorous physical

activity per week (self-report) [1], the demand for individual exercise

advice especially during cancer treatment is high. A possible reason for

this could be that many patients feel insecure about risking an increase in

cancer therapy-associated side eects due to the exercise training. Even

though a combination of aerobic and resistance training is recommended,

many patients have only been doing aerobic exercise before consultation.

erefore, most of them asked for a referral to a training institution to

start a resistance training.

Conclusion: e SOC is a valuable opportunity for cancer patients to

obtain information regarding exercise and help to (re-)start training.

erefore, there is a need for continuation and expansion.

Indication of source:

1 Schmitz KH, Courneya KS, Matthews C, et al. American College of Sports

Medicine roundtable on exercise guidelines for cancer survivors.Med Sci

Sports Exerc.2010;42(7):1409–1426.

Disclosure Statement: e authors declare no conict of interest.

1071

Establishing a centralized multidisciplinary unit for patient-

centered supportive care

Theres Fey1,10; Julia Demmelhuber2; Nicole Erickson1; Marina Schmid2;

Sylvia Tanzer-Küntzer3; Michael Schönberg4; Wolfgang Hiddemann5;

Markus Besseler6; Friederike Mumm1,7; Andreas Dinkel8; Hana Algül2,3,9;

Volker Heinemann1,2,10

1Comprehensive Cancer Center (CCC Munich LMU), Ludwig Maximilian

University (LMU) Hospital Munich, München, Deutschland

2Comprehensive Cancer Center Munich (CCC Munich), München, Deutschland

3Comprehensive Cancer Center (CCC Munich TUM), Klinikum rechts der Isar,

Technical University Munich, München, Deutschland

4Patient Advisory Board, Comprehensive Cancer Center Munich (CCC Munich),

München, Deutschland

5lebensmut e.V., Munich, München, Deutschland

6Bavarian Cancer Society e.V., Munich, München, Deutschland

7Department of Medicine III, Ludwig Maximilian University (LMU) Hospital

Munich, München, Deutschland

8Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts

der Isar, Technical University Munich, München, Deutschland

9Department of Internal Medicine II, Klinikum rechts der Isar, Technical

University Munich, München, Deutschland

10Bavarian Cancer Research Center (BZKF), Ludwig Maximilian University (LMU)

Hospital Munich, München, Deutschland

Background: As the landscape of cancer care becomes ever more multi-

faceted and complex, the incorporation of patient perspectives is critical

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 259

for the delivery of quality care. erefore, the CCC Munich, in coopera-

tion with the Bavarian Cancer Society and the charity lebensmut, aimed

to establish a centralized patient-centered (PC), low threshold, multidis-

ciplinary supportive care center capable of addressing patients’ individual

needs.

Methods: To ensure adequate incorporation of patient perspectives, a

patient advisory board worked together with a management board to plan

and establish the center. At every step, the focus remained on addressing

all aspects of PC care ranging from aesthetics to appropriate communica-

tion channels, and, most importantly, which supportive care requirements

to prioritize. Rooms were reserved for patient support groups to hold their

meetings. A central oce ensured an ease of coordinated care and man-

agement of patient enquiries.

Result: e CCC Munich patient center (Patientenhaus am CCC

München) was inaugurated in 2022. During the planning phase, patients’

needs were evaluated, while structural and personnel requirements were

dened according to existing standards. Within the rst year, 4101 con-

sultations were carried out. ese included psychosocial support services

including programs for families, elderly and children (62 %), as well as

consultations with specialist from the areas of nutrition (26 %) and com-

plementary medicine (12 %). Presently, an integration of counseling ser-

vices for physical activity and pain management are being evaluated.

Discussion: e supportive care center sets a precedent for foundational

structures facilitating PC care. e patient advisory board ensured that

essential gaps and information needs were satisfactorily addressed.

Conclusion: Streamlined comprehensive supportive care is essential for

the delivery of high quality PC-care. e establishment of the supportive

care center sets the foundational structures required to adjust to, and ade-

quately address, the patient needs.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

992

Bridging the gap and providing support for seriously ill

patients and their families: The “Buddy” intervention as a

result of the Dying at Home project.

Alina Kasdorf1; Raymond Voltz1; Julia Strupp1

1Uniklinik Köln, Köln, Deutschland

Background: e health and social care structures available for seriously

ill patients are still not always adequately used. For example, palliative care

is still provided late in the disease process, as opposed to early integration.

erefore, we wanted to dene elements of a complementary support sys-

tem for seriously ill and dying patients, based on specic experiences.

Methods: Qualitative interviews (patients & relatives, n=45) and focus

groups (health care professionals, n=22) were conducted and analysed

using framework analysis (Kasdorf et al. 2023).

Result: Informants described needs in emotional, informational, appraisal

and instrumental dimensions. Unmet informational needs were the most

frequently reported, aecting all other dimensions of need. To address

these concerns, informants expressed a need for someone to proactively

provide real-time support, organise respite care, provide feedback on care,

help understand the patient’s illness, or assist with nancial or legal issues.

Discussion: Inadequate knowledge of available treatment options aects

people’s multiple needs and increases the likelihood of death in hospital

(Kasdorf et al, under review). e implementation of a ‘buddy’ system

emerged as a potential solution to link current care structures and meet

the needs of patients and families. Seriously ill patients would be matched

with trained ‘buddies’.

Conclusion: Following on from this project, the Buddy system has been

implemented in Cologne with funding from the Dt. Fernsehlotterie. It has

the potential to alleviate emotional distress, improve patients’ and fam-

ilies’ coping mechanisms and promote a better quality of life. Funding

from the Marga and Walter Boll Foundation is being used to evaluate the

implementation.

Indication of source:

1 Kasdorf, A., Voltz, R. & Strupp, J. e Buddy intervention: designing an

additional support system for the last year of life. J Public Health(2023).

2 Kasdorf, A., Voltz, R. & Strupp, J. (under review). Dying at home: What is

needed? A nationwide retrospective cross-sectional online survey of bereaved

people.

Disclosure Statement: e authors declare no conict of interest.

1088

Supporting the implementation of quality-assured

oncological exercise therapy in Germany: protocol of the

IMPLEMENT project

Melanie Reitz1; Mirko Brandes2; Anika Berling-Ernst1; Dominik Morlok3;

Annalena Wehner4; Bernardine Madl5; Patrick Jahn6; Thorsten Schmidt7;

Wiebke Jensen8; Miriam Götte9; Michael Leitzmann3; Hajo Zeeb2;

Freerk T. Baumann1

1CIO - Centrum für Integrierte Onkologie Uniklinik Köln, Köln, Deutschland

2Leibniz-Institut für Präventionsforschung und Epidemiologie - BIPS, Bremen,

Deutschland

3Universität Regensburg, Regensburg, Deutschland

4Ludwig-Maximilians-Universität München, München, Deutschland

5Technische Universität München, München, Deutschland

6Universitätsklinikum Halle (Saale), Halle (Saale), Deutschland

7Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Deutschland

8Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland

9Universitätsklinikum Essen, Essen, Deutschland

Background: Quality-assured oncological exercise therapy (qOET) is

oen not implemented in routine cancer care, although it can improve

patient outcomes. erefore, the 3-year multicenter project IMPLEMENT

aims to develop, test and evaluate strategies to implement a sustainable

pathway to qOET with the primary goal to increase the overall number of

patients accessing qOET

Methods: IMPLEMENT uses a mixed-methods-approach to tackle bar-

riers and facilitators of the implementation of qOET, which are identied

at baseline. e project is structured by ve subprojects designing and

conducting strategies to implement qOET in specic settings and target

groups (e. g., urban vs. rural areas, adults vs. pediatric patients). Outcome

assessments occur at baseline, one- and two-years follow-up and are

guided by the RE-AIM framework, using questionnaires (patients: n=600;

stakeholders: n=210 per year) and semi-structured interviews and focus

groups (patients: n=24; stakeholders: n=24 per year). Outcome assess-

ments are used to revise and improve the implementation strategies of

each subproject. Project start was June 2023.

Result: IMPLEMENT aims at an increase (median 30%) of the number of

cancer patients that participate in qOET (primary outcome). Secondary

outcomes include the extension and adaption of qOET as well as an

increase of self-reported quality of life of cancer patients.

Discussion: Given the variety of stakeholder and patient groups involved

in the sustainable implementation of qOET, the interplay of various bar-

riers and facilitators in establishing qOET should be investigated further.

Innovative, evidence-based implementation strategies could then help to

overcome the identied barriers and promote facilitators. is could help

ensure sustainable access structures to qOET in Germany.

Conclusion: e use of eective implementation strategies may be bene-

cial for establishing qOET throughout Germany and could be promising

items to implement qOET in routine cancer care.

Disclosure Statement: e authors declare no conict of interest.

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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts260

Surgical Oncology including Robotics

1012

Feasibility study of sentinel lymph node diagnosis using free

ICG in testicular cancer patients

Yue Che1,1; Marieke Vermeulen1; Pailin Pongratanakul1; Sophia Thy1;

Peter Albers1

1UKD - Universitätsklinikum Düsseldorf- Urologische Klinik, Düsseldorf,

Deutschland

Background: Current staging methods at initial diagnosis fail to detect

occult metastasis in testicular cancer patients. Risk-adapted strategies to

reduce recurrence recommend adjuvant chemotherapy in cases of high

risk. Depending on testicular histology, 50% to 70% of those patients do

not need adjuvant chemotherapy. Since chemotherapy induced toxicity

is associated with considerable late toxicities and secondary malignan-

cies initial staging needs to be improved. Prior pilot studies investigat-

ing sentinel lymph node diagnosis using radioactive tracers in testicular

cancer patients have shown a high sensitivity (~90%) of the procedure.

erefore, we oered minimally-invasive sentinel lymph node biopsy

with free ICG to four patients with unequivocal testicular tumors in

clinical stage I.

Methods: Preoperative thoracoabdominal staging showed no evidence

of metastases in all patients. We performed laparoscopic or robotas-

sisted ICG-guided sentinel lymph node biopsy with simultaneous

orchiectomy in four men with initial diagnosis of testicular cancer in

clinical stage I.

Result: Sentinel lymph nodes were identied and resected in all patients

(see gure). e operations were well tolerated and no complications

regarding sentinel resection were observed.

Conclusion: Laparoscopic/robotic-assisted ICG-guided sentinel lymph

node detection with simultaneous inguinal orchiectomy in testicular

cancer patients is feasible. Sensitivity to detect occult metastatic dis-

ease of this novel technique will now be evaluated in a prospective trial

(RAISN).

Disclosure Statement: e authors declare no conict of interest.

Thoracic Cancer

1022

Amivantamab Plus Lazertinib vs Osimertinib as First-line

Treatment in Patients With EGFR-mutated, Advanced Non-

small Cell Lung Cancer (NSCLC): Primary Results From

MARIPOSA, a Phase 3, Global, Randomized, Controlled Trial

(Previously presented at ESMO Congress 2023, FPN:LBA14,

Byoung Chul Cho et al. - Reused with permission.)

Martin Schuler1; Byoung Chul Cho2; Enriqueta Felip3; Alexander Spira4;

Niolas Girard5; Jong-Seok Lee6; Se-Hoon Lee7; Yuriy Ostapenko8;

PongwutDanchaivijitr9; Baogang Liu10; Adlinda Alip11;

ErnestoKorbenfeld12; Josiane Mourão13; Tao Sun14; Melissa Martinez14;

Joshua Bauml15; Martin Shreeve16; Seema Sethi15; Roland Knoblauch15;

Hidetoshi Hayashi17; Shun Lu18

1Universitätsklinikum Essen, Essen, Deutschland

2Yonsei Cancer Center, Seoul, Republik Korea

3Vall d’Hebron University Hospital, Barcelona, Spanien

4Virginia Cancer Specialists, Fairfax, USA

5Institut du Thorax Curie Montsouris, Paris, Frankreich

6Seoul National University Bundang Hospital, Seongnam-si, Republik Korea

7Samsung Medical Center, Seoul, Republik Korea

8National Cancer Institute, Kyiv, Ukraine

9Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

10Harbin Medical Univ. Cancer Hosp., Heilongjiang, China, VR

11Universität Malaya, Kuala Lumpur, Malaysia

12Hospital Británico de Buenos Aires, Buenos Aires, Argentinien

13Hospital de Amor, Barretos, Brasilien

14Janssen Research & Development, Llc, Raritan, USA

15Janssen Research and Development, Spring House, USA

16Janssen R&D, San Diego, USA

17Kindai University Faculty of Medicine, Osaka, Japan

18Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong

University, Shanghai, China, VR

Background: Amivantamab (ami), an EGFR-MET bispecic antibody

with immune cell-directing activity, plus lazertinib (laz), a CNS-penetrant,

3rd-generation EGFR TKI, have demonstrated antitumor activity in phase

1 studies. MARIPOSA (NCT04487080) evaluated ami+laz vs osimertinib

(osi) in the rst-line setting.

Methods: Patients (pts) with treatment-naïve, EGFR-mutated (Ex19del or

L858R) locally advanced or metastatic NSCLC were randomized 2:2:1 to

ami+laz (open-label), osi (blinded), or laz (blinded). e primary end-

point was progression-free survival (PFS) of ami+laz vs osi by blinded

independent central review. Secondary endpoints included objective

response rate (ORR), duration of response (DoR), overall survival (OS),

and safety. Serial brain imaging was required.

Results: In total, 1074 pts were randomized (ami+laz, 429; osi, 429; laz,

216). Baseline characteristics were well balanced; median age was 63 years,

62% were female, 59% Asian, and 41% with history of brain metastases.

At a median follow-up of 22.0 months, the median PFS was 23.7 months

(95% CI, 19.1–27.7) for ami+laz and 16.6 months (95% CI, 14.8–18.5) for

osi (HR, 0.70; 95% CI, 0.58–0.85; P<0.001); this benet was consistent

across predened subgroups. ORR was 86% (95% CI, 83–89) for ami+laz

vs 85% (95% CI, 81–88) for osi, with median DoR of 25.8 months (95% CI,

20.1–NE) vs 16.8 months (95% CI, 14.7–18.5) among conrmed respond-

ers. At interim OS analysis, the medians were not reached; however, a

strong trend favored ami+laz vs osi with an HR of 0.80 (95% CI, 0.61 to

1.05; P=0.1).

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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 261

Ami+laz was associated with a higher rate of VTE; mostly grade 1-2,

occurring early, and eectively managed with anticoagulation. Higher

rates of EGFR- and MET-related AEs were seen with ami+laz vs osi.

Conclusion: Ami+laz provided statistically signicant and clinically

meaningful improvement in PFS vs osi with a numerically higher DoR

and a strong trend for improved OS. e safety prole of ami+laz was

consistent with prior reports. MARIPOSA establishes ami+laz as a new 1st

line standard of care for EGFR-mutated, advanced NSCLC.

Disclosure Statement: e authors declare that there are conicts of interest. e

conicts were submitted to the congress organizer KUKM GmbH and KUKM can

disclose them if needed.

Translational Oncology

1086

Radiation sensitivity is signicantly increased in patients with

systemic lupus erythematosus and the dose can be adjusted

for radiotherapy

Luitpold Distel1; Hannah Schenker1; Lukas Kuhlmann1; Rainer Fietkau1

1Strahlentherapie, Universitätsklinikum Erlangen, Erlangen, Deutschland

Background: ere are repeated clinical reports that patients with sys-

temic lupus erythematosus (SLE) have a higher risk of suering adverse

treatment eects. It is therefore assumed that these patients have an

increased radiation sensitivity. We studied 70 patients with SLE for their

radiation sensitivity. In the case of increased radiation sensitivity, we rec-

ommended a dose reduction for the therapy.

Methods: Using a G0-3C FISH assay of blood from patients, the radia-

tion sensitivity was determined via a score (breaks per metaphase, B/M)

of chromosomal aberrations. 37 non-oncological SLE and 33 SLE patients

with an oncologic disease were studied. Healthy individuals (n = 215)

and patients with breast (n = 147) and rectal cancer (n = 226) served as

controls.

Result: Patients with SLE were comparable in radiation sensitivity (B/M

0.40) to healthy individuals (B/M 0.41), but had signicantly more outli-

ers (10.8% > 0.6 B/M) to high radiation sensitivity comparable to patients

with breast (11.9%) or rectal cancer (11.6%). SLE patients with oncologic

disease have a signicantly increased mean radiation sensitivity of 0.52

B/M and a 24.2% outlier rate. e radiation sensitivity is clearly higher

than in patients with breast (B/M 0.45) or rectal cancer (B/M 0.44) (p <

0.007). A dose reduction of between 2% and up to 40% was recommended

for 11 patients. In two of these patients no radiotherapy was performed

and in 4 patients the dose was not reduced despite the recommendation.

5 patients received a dose reduction of up to 20%. None of the patients

developed a recurrence. One patient in whom the dose was not reduced

suered a serious adverse treatment outcome.

Discussion: Increased radiation sensitivity is found in all cohorts.

However, with very dierent numbers of increased radiation sensitivity

and severity.

Conclusion: Approximately 50% of SLE patients with oncologic disease

have a signicantly increased sensitivity to radiation. Reducing the dose of

radiation therapy is a practical way to avoid unwanted side eects.

Disclosure Statement: e authors declare no conict of interest.

1040

Analysis of ctDNA for the detection of minimal residual

disease (MRD) using a tissue-free, epigenomic assay in

patients with early-stage breast cancer - results from the

Success A study

Thomas W. P. Friedl1,1; Brigitte Rack1; Peter Andreas Fasching2;

AndreasHartkopf3; Hans Tesch4; Ralf Lorenz5; Georg Heinrich6; Jens-

UweBlohmer7; Tanja Fehm8; Volkmar Müller9; Andreas Schneeweiss10;

Matthias Beckmann2; Matthias Rübner2; Nadia Harbeck11; Klaus Pantel12;

Derek Dustin13; Mingyang Cai13; Wolfgang Janni1

1Frauenklinik, Universitätsklinikum Ulm, Ulm, Deutschland

2Frauenklinik, Universitätsklinik Erlangen, Erlangen, Deutschland

3Frauenklinik, Universitätsklinikum Tübingen, Tübingen, Deutschland

4Onkologie Bethanien, Frankfurt, Deutschland

5Praxis Dr. Lorenz, N. Hecker, Dr. Kreiss-Sender, Braunschweig, Deutschland

6Schwerpunktpraxis für Gynäkologische Onkologie, Fürstenwalde, Deutschland

7Gynäkologie mit Brustzentrum, Charité-Universitätsmedizin Berlin, Berlin,

Deutschland

8Frauenklinik, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland

9Klinik und Poliklinik für Gynäkologie, Universitätsklinikum Hamburg-

Eppendorf, Hamburg, Deutschland

10National Center for Tumor Diseases (NCT), Heidelberg University Hospital and

German Cancer Research Center, Heidelberg, Deutschland

11Frauenklinik, LMU Klinikum München, München, Deutschland

12Institut für Tumorbiologie, Universitätsklinikum Hamburg-Eppendorf,

Hamburg, Deutschland

13Guardant Health, Palo Alto, CA, USA

Background: Current clinical guidelines do not recommend routine

screening for metastatic disease in patients with early-stage breast cancer

(EBC) unless there are clinical signs and symptoms. However, ctDNA may

serve as an early biomarker of recurrence which could facilitate identica-

tion of patients with asymptomatic distant metastases, who might benet

from early treatment intervention. Here, we utilized a tissue-free, epig-

enomic assay for the detection of ctDNA in patients with EBC.

Methods: Plasma samples were analyzed in 311 evaluable patients with

stage I-III EBC who were enrolled in the SUCCESS-A phase 3 clinical

trial (NCT02181101). All plasma samples were collected approximately

two years aer completion of adjuvant chemotherapy from patients with-

out evidence of prior disease recurrence. Samples were assessed blinded

to the clinical data using Guardant Reveal powered by Innity, which

evaluates the epigenomic signals associated with cancer versus normal

DNA for the detection of ctDNA, using an analytically validated bioinfor-

matics pipeline. Median survival times were estimated using the Kaplan-

Meier method and hazard ratios were calculated based on univariable cox

regression models.

Result: ctDNA was detected in 34% (13/38) of patients who subse-

quently developed distant recurrence (median time from sample col-

lection to recurrence 7.9 months, range 1.4-28.6 months), and in 60%

(9/15) of patients who had a sample collection within one year prior to

distant recurrence. ctDNA was detected in 6 patients without a docu-

mented disease recurrence, resulting in a specicity of 97.7% (260/266).

ctDNA detection was associated with a nearly 14-fold increased risk for

distant recurrence (HR 13.7, 95% CI 2.52-74.9; p<0.0001), and a 17-fold

increased risk for death (HR 17.4, 95% CI 1.33-227; p<0.0001).

Conclusion: Detection of ctDNA aer adjuvant chemotherapy was highly

prognostic in an EBC cohort. ctDNA testing warrants further investiga-

tion as a tool to identify EBC patients at high risk for recurrence during

follow-up who may benet from early interventions.

Disclosure Statement: e authors declare the following: D.D. and M.C. are em-

ployees of Guardant Health. All other authors declare no conict of interest.

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Abada, P. 549, 578

Abbas, S. 282, 285

Abdallah, Al-O. 237

Abdollahi, A. 368

Abdulkhalek, H. 61, 149

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Abicht, A. 577

Abonour, R. 43

Abou-Alfa, G. 351, 370, 377

Aboukors, T. 268

Abraham, K. 168

Abreu, Miguel H. 196

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Acebo, R. 753

Acker, F. 947

Adeberg, S. 306, 368, 938, 1123, 1126

Adelberg, D. 818

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Agius, M. 828

Aguado-Barrera, Miguel E. 481

Ahmad Khalil, D. 704, 717, 821

Ahmed, Helal Mohammed M. 712

Ahn, Jin S. 1018

Ahn, Myung-J. 360, 989

Ahrens, M. 100

Aigner, A. 901

Aigner, C. 511

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Akerley, W. 674

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Assenat, E. 351

Asuzano, A. 1138

Atmaca, A. 360, 989

Atzpodien, J. 875

Auber, B. 275

Audigier-Valette, C. 571

Aufenberg, B. 777

Augustin, M. 1020

Aulitzky, Walter E. 768

Autry, Robert J 44

Avilion, A. 262

Awada, A. 182

Ayala, R. 251

Aydogdu, C. 100

Azevedo, S. 351

Aznar-Peralta, I. 524

Azria, D. 481

Azqueta Gavaldon, M. 1074

Baader, T. 672

Baas, P. 360

Babiak, A. 636

Babiak, C. 636

Bachanek, S. 834, 839

Bachet, Jean-B. 711

Backman, M. 212

Baehr, A. 75, 358, 379, 528

Baerens, Dirk-T. 61

Bahlis, Nizar J 43, 1060

Bähr, O. 811

Balint, N. 994

Baltus, H. 1130

Bajwa, N. 260

Balbas, M. 549, 567

Baldus, S. 96, 744

Balduzzi, A. 672

Balic, M. 49

Balk, M. 758, 808

Ball, C. 734

Baltas, D. 750, 890

Balzer, K. 419

Bamias, A. 1057

Banerjee, S. 270

Banerji, V. 278

Bangemann, N. 912

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Oncol Res Treat 2024;47(suppl 1):7–283Author Index 263

Baran, C. 951

Barbato, F. 228

Bardelli, A. 305

Bardia, A. 214

Barlesi, F. 1018

Barnes, B. 629

Barreau, Y. 709

Barrett, C. 1074

Barrios, C. 175, 196

Barth, T. 732

Barth, U. 591, 597

Bartl, T. 450, 744

Bartsch, Detlef K. 856

Bartsch, R. 49, 61

Barzel, A. 1122

Bäsecke, J. 191

Bassermann, F. 748

Bastians, H. 876

Battista, M. 154, 183, 290, 593

Batus, M. 62

Batzianouli, E. 804

Bauer, L. 49

Bauer, L. 306, 938

Bauer, N. 812

Bauer, S. 233, 704, 717, 821

Bauer-Büntzel, C. 773

Baues, C. 378

Baum, F. 581

Baum, J. 994

Baumann, E. 594, 681

Baumann, Freerk T. 35, 240, 638, 807,

923, 932, 946, 1088

Baumann, L. 769

Baumann, S. 190, 843

Bäumer, C. 704, 717

Baumgarten, P. 831

Baumgartl, M. 769

Baumhoer, D. 825

Bauml, J. 1022

Baurecht, H. 990

Bausewein, C. 195, 354, 371, 670

Baust, K. 56, 207, 630

Bayer, O. 878

Baz, R. 237, 334, 1060

Baz, David V. 989

Bechmann, I. 901

Beck, F. 852

Beck, J. 589

Beck, M. 528, 551

Beck, S. 598

Becker, C. 618

Becker, H. 661

Becker, H. 630, 675

Becker, J. 331

Becker, K. 577

Becker, L. 44

Becker, N. 802

Becker, S. 48, 51

Becker, S. 345

Becker, S. 949

Beckmann, H. 121, 582

Beckmann, Matthias W. 402, 483, 484, 541,

624, 747, 810, 1040

Bedir, A. 134

Beer, A. 732

Beghdad, F. 61

Behr, J. 885

Behrens, H.-M. 1058

Behrens, S. 644

Behringer, D. 689

Behringer, K. 318, 589

Beierlein, M. 483

Beil, J. 595

Bekaii-Saab, T. 818

Belka, C. 769, 877

Belle, S. 913

Beller, R. 240, 431, 916

Belloso, J. 536

Beltzig, L. 1103

Ben Hamed, H. 153

Bence-Lin, A. 1131

Bende, K. 1124

Bendrich, S. 327

Bendszus, M. 610, 861, 867

Benet-Pagès, A. 858

Benjamin, R. 1060

Benner, A. 644, 802

Bennstein, Sabrina B. 916

Benz, S. 892

Benz, Stefan R. 581, 629

Berdeja, J. 1060

Berdel, W. 712

Bergatt-Kuhl, B. 271

Bergbold, S. 298

Berger, A. 853, 856

Berger, K. 650, 786

Berger-Höger, B. 650

Berghmans, T. 674

Bergmann, Anke K. 594, 782

Bergner, D. 211

Berking, C. 561

Berling-Ernst, A. 990, 1088, 1132

Bernabe Caro, R. 62, 571

Bernardi, C. 673, 701

Bernauer, E. 1026

Berndt, U. 486

Berner, R. 952

Bernhardt, D. 1084

Bernstein, S. 584

Berressem, S. 558, 687, 693

Berry, M. 384

Bertemes, H. 620

Besseler, M. 878, 1071

Bette, M. 325

Beule, D. 332, 449

Beutel, Alica K. 1141

Beuzeboc, P. 1057

Beverungen, D. 76

Bey, I. 696

Bhatnagar, R. 43, 237, 1060

Biebl, M. 417

Bielack, S. 825

Bier, S. 655

Bigot, F. 995

Bijlsma, Rhode M. 536

Bilici, M. 1000

Bilsing, B. 707

Binder, C. 246

Bini, F. 153

Birkhold, M. 873

Bischof, G. 190, 843

Bischo, M. 689

Bischo, P. 376, 396

Blanc, E. 332, 449

Blanc, Jean-F. 708

Blanck, O. 854

Blase, C. 821

Blatt, S. 160

Blau, W. 689

Blaum, T. 275

Blaurock, M. 424

Blay, Jean-Y. 301

Blazejczyk, K. 632

Bleckmann, A. 246, 514, 947

Blees, A. 697

Blickle, P. 210

Bloch, W. 536, 672

Blohmer, Jens-U. 283, 346, 364, 668,

912, 1040

Blome, C. 121

Blöß, S. 819

Blum, S. 571

Blümcke, B. 275

Blumenschein Jr, G. 360

Blütgen, S. 740

Bochtler, T. 995

Böck, S. 88

Bockelmann, A. 876

Boda-Heggemann, J. 854

Bodensohn, R. 358

Boehmer, U. 27

Boekels, R. 833, 842

Bögemann, M. 37, 74, 116, 265

Böger, D. 447

Bogeski, I. 764

Bohle, R. 1124

Böhler, P. 282

Böhlke, L. 638

Böhm, C. 1136

Böhmer, D. 319, 816

Böhmer, G. 355

Bohne, A. 230, 439

Bohnenkamp, H. 878

Boileau, J.-F. 175

Boje, Ammelie S. 800

Bojovic, V. 723

Bokemeyer, C. 35, 240, 247, 406, 557,

569, 572, 637, 733, 737,

738, 965

Böker, A. 709

Bokhua, D. 956, 958

Boklage, S. 576

Bolenz, C. 913, 1122

Bolli, M. 612

Bolm, L. 446

Bolt, T. 885

Bölükbas, S. 511, 756

Bondarenko, I. 1018

Bonifacio, M. 251

Bonilla del Rio, Z. 764

Bonke, Lars A. 424

Borchmann, P. 262, 318, 378, 589

Bordogna, W. 1018

Borger, V. 516, 945

Borges, G. 926

Borghaei, H. 571

Borgmann-Staudt, A. 207, 630

Borgwardt, Luca-P. 962

Borkar, S. 700

Borkhardt, A. 888

Borkowetz, A. 986

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Oncol Res Treat 2024;47(suppl 1):7–283 Author Index264

Borm, K. 1084

Bornhäuser, M. 686, 859, 866

Börries, M. 581, 620, 661

Bösche, J. 560, 687, 713

Boschung, K. 1136

Boshnakovska, A. 764

Bossart, M. 661

Bosse, K. 1095

Böthig, J. 594

Böttcher, C. 376

Böttcher, S. 308

Böttinger, R. 809

Bouattour, M. 66

Boukovala, M. 786

Boulet, T. 1053

Bourgeois, M. 239, 875

Bourjlian, Shogheeg A. 260

Boxberg, M. 598, 851

Boyer, L. 673, 701

Boyle, F. 1085

Bragagnoli, A. 70

Brägelmann, J. 893

Brahmer, Julie R. 571

Braicu, Elena I. 107

Brand, M. 268

Brandes, M. 1088

Brandt, R. 1081

Braner, H.-U. 1112

Brasó-Maristany, F. 484

Bratan, T. 667

Braulke, F. 327

Braumann, C. 770, 776

Braun, Felix L. 411

Braun, R. 446

Brecht, P. 745

Breder, V. 377

Brehmer, B. 906

Breitbach, M. 741

Breitbart, Eckhard W. 859, 920

Breitling, A. 513

Breitschuh, D. 687, 713

Bremen, R. 467

Brenner, H. 585, 651

Brenner, W. 183

Breuel, S. 845

Brieu, N. 1074

Bridge, H. 343

Brieger, J. 647

Briers, E. 481

Brigitte, S. 594, 782

Brinkers, M. 940

Brix, G. 135

Bröckelmann, Paul J. 318, 847

Broehl, M. 721

Broge, B. 499

Broijl, A. 43, 1060

Bronsert, P. 446, 724, 795, 944

Brose, M. 1133

Brossart, P. 304

Brown, Jennifer R. 549

Brucker, C. 107

Brückl, W. 274, 947

Brückner, L. 541

Bruges, R. 70

Brüggemann, M. 76

Brümmendorf, Tim H. 467

Brunner, C. 460

Brunner, F. 308

Brunner, T. 854

Bruns, Christiane J. 88, 590, 856, 934

Bruns, G. 878

Bruns, J. 629

Brust, Lukas A. 411

Brüstle-Wild, A. 1009

Brzezicha, B. 600

Brzoska, P. 909

Büch, T. 901

Buchele, C. 769

Buchholz, M. 770, 776

Buchholz, S. 856

Büchler, B. 212

Budach, W. 854

Budczies, J. 598, 851

Budginaite, E. 767

Bugaj, Till J. 178, 185, 659

Buhl, C. 455

Bühnen, I. 318

Bukatz, J. 396

Bullinger, L. 396, 1143

Bultijnck, R. 1011

Büntzel, J. 447, 458, 773

Büntzel, J. 381, 429, 773, 780, 790

Burger, L. 911

Burgers, Jacobus A. 571

Burkhardt, V. 618

Bürkle, Sophia L. 890

Burner-Fritsch, I. 670

Burotto, M. 1057

Burris, H. 66

Büscher, A. 613

Busenhart, P. 657

Bushong, J. 571

Buss, E. 999

Butea-Bocu, Marius C. 54

Büthe, L. 381

Butler, M. 271

Buttmann-Schweiger, N. 829

Büttner, R. 716, 893, 965, 1136

Byrd, John C. 278

Cabrieto, J. 697

Cai, M. 1040

Caia, A. 43, 237, 334, 1060

Cairns, L. 149

Calaminus, A. 893

Calaminus, G. 35, 56, 207, 240, 630

Califano, R. 62

Callander, N. 334, 1060

Cameron, S. 910

Campbell, A. 1

Canão, P. 767

Capdevilla, J. 711, 1133

Capper, D. 291, 368, 396

Carbasse, C. 435

Cardona, A. 1018

Cardoso, R. 585

Cario, G. 526

Carmen Garrido-Navas, C. 524

Carreño Gonzalez, Martha J. 1120

Carreras, Francisco G. 784

Cartron, G. 262

Casadei, N. 1073

Castro, G. 62

Castro Oliden, V. 1000

Casuscelli, J. 100, 906

Catanzariti, L. 893

Cathomas, R. 100

Cavo, M. 334, 1060

Ceranski, A. Katharina 1120

Cercek, A. 711, 818

Ceresoli, G. 574

Chaganti, S. 722

Chalabi, N. 995

Chan, Stephen L. 351, 370, 377

Chandak, A. 384, 918

Chang-Claude, J. 481, 644

Chao, J. 367

Che, Y. 1012

Cheah, Chan Y. 549, 567, 578

Chelik, G. 865

Chen, C. 43, 334, 1060

Chen, C. 140

Chen, E. 711

Chen, G. 94

Chen, H. 735

Chen, Jen-S. 66

Chen, Ming-H. 708

Cheng, Ann-L. 351

Cheng, Y. 1108

Chiang, M. 918

Chima-Melton, C. 384, 918

Cho, Byoung C. 360, 1022

Cho, L. 576

Choidas, A. 184

Chong, G. 502

Choquet, S. 722

Choritz, L. 665

Choudhury, A. 481

Chow, Edward Kai-H. 682

Christalle, E. 379

Christen, Deborah K. 1089

Christmann, J. 1055

Christmann, M. 1103

Christoph, D. 445, 755, 756, 947

Christoph, J. 153

Chui, S. 175

Chul Cho, B. 1056

Cicin, I. 423

Cidre-Aranaz, F. 1120

Cinci, M. 833, 842

Ciuleanu, Tudor-E. 571

Civardi, T. 335

Claaßen, K. 298, 848, 882

Clark, A. 722

Claßen, Noa M. 729

Claus, K. 754

Clauss, D. 212, 536

Cleary, James M. 70, 273

Clemens, P. 528

Clemens, R. 828

Cluzeau, T. 336, 1051

Cobo, M. 674

Cobo, Manuel A. 989

Cobo Dols, M. 1056

Coburger, J. 518

Cocks, K. 1131

Coen, L. 862

Cohen, G. 66, 372, 708

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Oncol Res Treat 2024;47(suppl 1):7–283Author Index 265

Cohen, J. B. 549, 567

Coker, S. 251

Colombo, N. 270

Combs, S. 1084

Combs, Stephanie E. 1125

Comoli, P. 722

Compton, Richard G. 735

Conrads, K. 876

Constantinovici, N. 94

Cook, M. 43, 237, 334, 106

Cook, N. 995

Coombs, Catherine C. 549, 578

Corbacioglu, S. 759

Cordesmeyer, L. 828

Cornelissen, R. 989

Corradini, S. 769

Cortes, J. 214, 1085

Cossmann, L. 874

Costa, I. 1076

Costa, Luciano J. 43, 334, 1060

Coto-Llerena, M. 609

Cox, A. 906

Crawford, D. 37, 74, 83

Croner, R. 517, 542, 550, 619,

621, 765, 954

Cruz, Felipe J. 74

Cruz, J. 196

Csapo-Schmidt, C. 368

Csűry, Anna Z. 758

Csűry, Tamás D. 758

Cuba, L. 22, 109

Cundom, J. 375

Cunningham, D. 779

Curigliano, G. 214, 762

Cymbalista, F. 278

Cytera, C. 207

Dabrowski, C. 576

Dahiya, S. 262

Dahl, E. 184

Dahlho, M. 726

Dahlmann, M. 267

Dahlum, S. 732

Dallal, A. 866

Dallmeier, D. 268

Danchaivijitr, P. 1022

Damaschin, C. 589

Damm, F. 343

Dannecker, C. 295, 537, 747

Dannehl, D. 741, 931

Dantes, Z. 468

Danzer, K. 1141

Dao, Tu V. 377

Dareskog, I. 664

Darr, C. 55, 95, 116, 228, 233, 906

Darsow, M. 515

Darwiche, K. 511, 1070

Das, S. 251

Dasari, A. 502

Dau, L. 384

Daubmann, A. 569

Daum, S. 856

Davenport, E. 140

Davids, Matthew S. 343

Davies, M. 61

Dayyani, F. 370

de Boer, C. 798, 962

De Bruin, N. 462

de Buhr, R. 49

de Gregorio, N. 107, 270

de Groot, Jan Willem B. 388

de Lazzari, N. 916

de Ligt, Kelly 1011

de Marinis, F. 576, 999, 1018

de Ruysscher, Dirk R. 481

De Toni, E. N 377, 1063

de Vrieze, M. 802

de Wit, M. 858

Debatin, Klaus-M. 426, 806

Debus, Jürgen P. 306, 769, 802, 938

Degerli, E. 415

Degulys, A. 336, 1051

Deiters, B. 276

Delank, S. 164

Delbridge, C. 1084

Delforge, M. 43, 334, 1060

Delmonte, A. 674

Deloch, L. 311

Demidov, G. 1095

Demmelhuber, J. 1071

Demmler, R. 79

Deng, M. 306, 938

Dengel, A. 462

Dengler, R. 403

Deniz, M. 801

Denkinger, M. 268

Dennert, G. 27

Denz, R. 1055

Denzlinger, C. 809

Depenbusch, J. 212, 536

Depke, M. 800

Deppe, I. 916

Derigs, P. 688, 911

Dernbach, G. 1136

Der-Torossian, C. 384

Desuki, A. 514, 714

Deutschmann, C. 253

Dexheimer, N. 1129

Dhanda, D. 1060

Di Bartolomeo, M. 711

Di Nicolantonio, F. 305

Di Pietro, A. 388

Diamante, G. 426

Didion, J. 884

Diehl, V. 378, 1084

Diels, J. 697

Diemert, S. 107

Dieng, S. 476

Dienstmann, R. 301

Diepers, A. 186

Diéras, V. 762

Dierickx, D. 722

Dierks, S. 798

Dierlamm, J. 378

Dieterich, M. 175

Dietlein, M. 378

Dietrich, A. 734

Dietrich, M. 973

Dietz, A. 615

Dietz, T. 560

Dikow, N. 275

Dimicoli-Salazar, S. 336, 1051

Dinkel, A. 1071

Dinkel, H. 55

Dirksen, U. 916

Distel, L. 297, 1086

Ditsch, N. 275, 295, 537

Dittmann, F. 828

Dittmar, T. 837, 841

Dittmer, K. 13

Dittrich, L. 417

Divarci, Reyhan R. 775

Djordjevic, M. 773

Dobiasch, S. 52

Doehn, C. 745, 868, 919, 922

Doerner, L. 518

Döge, C. 558

Doherty, Gary J. 345

Döhner, H. 732

Dolf, A. 792

Doll, K. 866

Dölvers, F. 645, 649, 690

Dooms, C. 1131

Domschikowski, J. 52

Dörje, F. 22, 80, 109

Dornhöfer, N. 314, 959, 960, 961

Dor-On, E. 702

Dörr-Jerat, Niels M. 324

dos Santos, Telma M. 367

Dossow, K. 619

Dracke, F. 560

Dragomir, Mihnea P. 1136

Drebber, U. 716

Dreger, P. 688

Dreiack, N. 331

Dreismann, L. 362

Dreismickenbecker, E. 333, 547, 672

Drewes, J. 940

Dreyling, M. 262, 567

Drießen, S. 93

Drilon, A. 1108

Dröge, Leif H. 327

Dröge, P. 56

Drzezga, A. 754

Duan, X. 722

Dubois, C. 594

Dudys, P. 653

Dugan, M. 893

Duhn, J. 446

Düll, J. 583

Dummer, R. 388

Durán-Pacheco, G. 995

Dürr, P. 22, 751

Dürst, M. 355, 573

Dustin, D. 1040

Duwe, G. 462, 735

Duyster, J. 620, 661

Dwinger, S. 35, 240

Dyer, Martin J. S. 817

Dziadziuszko, R. 62, 1018

Eaton, M. 674

Eberhardt, J. 862

Eberhardt, W. 511, 1070

Eberl, M. 496

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Oncol Res Treat 2024;47(suppl 1):7–283 Author Index266

Eberle, F. 1123

Ecker, J. 694, 814, 852

Eckstein, M. 758, 1124

Edelmann, F. 994

Edemir, B. 186

Edgar, S. 267

Ecace, F. 1011

Egenolf, T. 100, 906

Egger-Heidrich, K. 207

Ehlers, Anna C. 1120

Eich, Hans T. 1054

Egle, D. 49

Egyed, M. 278

Ehlert, S. 153

Ehret, F. 52, 291, 311, 358, 368, 396, 729

Eich, Hans-T. 378

Eich, Marie-L. 716, 754

Eichenauer, Rolf H. 868, 919, 922

Eichkorn, T. 306

Eichler, MSc., M. 686

Eilers, L. 350, 544

Eils, E. 1081

Einhell, S. 433, 701, 781

Einsele, H. 43, 237, 583

Eisele, L. 697

Eisemann, N. 1130

Eisen, A. 181

Eisen, C. 1074

Eisfeld, C. 233, 882

Eixelberger, T. 913

Ekmekciu, I. 1055

Elamin, Y. 1108

Elbracht, M. 979

Eli Gabayan, A. 1056

Eliason, L. 1060

Elisei, R. 1133

El Rajab, I. 672

El Shae, R. 327, 528

Elimova, E. 70, 140, 273

Ellenrieder, V. 764, 876

El-Marouk, K. 415

Elmers, S. 35, 240

Elter, T. 760, 899

Emmanuel, K. 493

Emmerson, J. 779

Emrich, K. 219

Eng, C. 502

Engebraten, O. 484

Engler, J. 1037

Engel, C. 275

Engel, H. 890

Engel, T. 170

Engert, A. 318

Engst, R. 143, 1090

Entlicher, M. 1008

Erber, R. 402, 810

Erbes, T. 661, 719

Ercan, C. 609

Erdmann, G. 653

Erices-Leclercq, M. 96, 744

Erickson, N. 990, 1063, 1071

Ernst, J. 796, 874

Ernst, M. 484, 624

Ernst, T. 447, 663

Escherich, G. 630

Eskoer, B. 483

Esposito, I. 785, 888, 965

Esposito, O. 251

Esser, Heinz-W. 899

Esser, K. 864

Ettrich, Thomas J. 188, 351, 531, 856,

884, 1141

Evers, G. 246, 947

Evesque, L. 66

Exner, Jan-P. 719

Eyl-Armbruster, Ruth E. 187, 809

Eyre, Toby A. 549, 567, 578

Eysel, P. 946

Eze, C. 415

Fabbri, G. 1074

Faber, J. 35, 207, 240, 333, 547, 630, 672

Fabian, A. 311

Facon, T. 335

Faehling, S. 437

Fahkri, B. 549

Fahmer, N. 444

Faker, F. 797

Fakhri, B. 567

Falk, M. 660

Faller, H. 444

Fam, F. 343

Farazi, T. 262

Fasan, O. 262

Fasching, Peter A. 402, 483, 484,

541, 624, 810, 1040

Fasolo, A. 351

Fasshauer, M. 910

Fassunke, J. 521, 736

Faust, M. 847

Faust, U. 1095

Feder, I. 1055

Fehm, T. 275, 402, 747, 810, 862,

864, 917

Fehn, T. 659, 1040

Fehrenbach, Michael K. 518

Feiten, S. 966

Felbor, U. 787

Feldmann, G. 239, 304

Feliciano, J. 273

Felip, E. 360, 1022

Feller, A. 236

Felser, S. 366, 424, 1089

Felten, J. 43, 237, 334, 1060

Fenaux, P. 336, 1051

Fendler, W. 228, 705, 848

Ferdinandus, J. 378, 589

Ferentinos, K. 755

Fernandez, Maria Elena E. 502

Fernández-Zapata, C. 376

Fernando, N. 1056

Ferrajoli, A. 260, 278

Ferrant, E. 278

Ferreira, L. 468

Ferro, A. 301

Fervers, P. 590

Fetzner, D. 446

Feuerbach, M. 984

Feufel, M. 283, 408, 409, 787

Fey, T. 786, 990, 1063, 1071

Fichtner-Feigl, S. 856

Ficker, J. 274

Fieber, V. 859, 866, 920

Fiengo Tanaka, L. 357, 495, 496, 829

Fietkau, R. 297, 808, 811, 1086

Filian, J. 1057

Fink, A. 402, 810

Fink, C. 769

Finke, I. 249

Finkelmeier, F. 66

Finogenova, K. 804

Fiorentini, C. 1132

Fischer, B. 975

Fischer, H. 646

Fischer, H. 797

Fischer, J. 327

Fischer, L. 239

Fischer, Laura A. 327

Fischer, M. 667

Fischer, Rieke N. 847

Fischer, T. 754

Fischer von Weikersthal, L. 188, 1020

Fishman, H. 702

Fiuza-Luces, C. 672

Fizazi, K. 37, 74, 83, 265

Flachmann, M. 838

Flaherty, Keith T. 388

Flatmark, K. 761

Flaucher, M. 483

Flebbe, H. 559

Flegar, L. 906

Flethe, C. 450

Fleury, I. 262

Flieger, D. 689

Flinn, Ian W. 278, 549, 567

Flock, C. 178, 185

Flockerzi, F. 616

Flohr-Schmitt, E. 878

Fogliatto, Laura M. 278

Folkerts, Jan H. 714

Follmann, M. 391, 747

Follows, G. 260, 278

Foltz, L. 784

Fong, Chung Y. 251

Forberger, M. 961

Forkel, H. 800

Forstbauer, H. 689

Förster, F. 96, 744

Förster, R. 96, 744

Forsting, M. 511

Fouad, Tamer M. 345

Foukakis, T. 484

Fox, F. 581

Fox, Maria L. 784

Fragoso Costa, P. 228

Francis, P. 536

Frank, D. 712

Franke, B. 581, 629

Franke, Gabriele H. 215

Franke, Georg-N. 76, 676

Franke, S. 757, 844

Franke, S. 615

Franken, A. 862, 917

Franz, S. 211

Freitag, D. 831

Freitag, M. 890

Fremd, C. 536

Frentsch, M. 1136

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Oncol Res Treat 2024;47(suppl 1):7–283Author Index 267

Frerich, B. 436

Freudlsperger, C. 306, 938

Frevert, Marie L. 741, 931

Freyer-Adam, J. 190, 843

Fridh, M. 672

Friederich, Hans-C. 185

Friedetzky, A. 722

Friedl, A. 187

Friedl, Thomas W. P. 402, 810, 917, 1040

Friedrich, C. 1136

Friedrich, N. 716

Friess, H. 856

Friker, Lea L. 363, 945

Fritz, R. 1136

Fröhlich, D. 813

Fröhling, S. 332, 449

Fromm, Martin F. 22, 80, 109

Frontzek, F. 1054

Frost, N. 396, 947, 1136

Früh, A. 396

Frühwald, M. 630

Fuchs, J. 306, 938

Fuchs, M. 318, 378, 589

Fuentes Pradera, J. 1056

Führer, D. 1133

Führes, Hannah S. 221

Fujera, M. 584

Fürst, A. 230, 417, 439

Furuse, J. 351, 370, 377

Gaebel, J. 615

Gaertner, B. 190, 843

Gahr, S. 385

Gaidzik, Verena I. 732, 884

Gainey, M. 719, 890

Gaisa, Nadine T. 732

Galy, G. 345

Gallardo, C. 70

Galldiks, N. 847

Galle, Peter R. 377

Gallmeier, E. 188, 856

Galsky, M. 1057

Gamelin, L. 722

Gao, S. 345, 1133

Garbaos, G. 345

Garbe, C. 388

Garbrock, K. 1137

Garcia-Carbonero, R. 502

Garcia-Manero, G. 336, 1051

Garcia-Marquez, Maria A. 88, 590

García-Sancho, Alejandro M. 262

Garhöfer, F. 610, 861, 867

Garrido, M. 70, 1000

Garrido, P. 1131

Gartner, L. 816

Gärtner, M. 966

Gasimli, K. 949

Gasimli, N. 949

Gašpert, T. 1011

Gast, M. 827

Gastinger, I. 954

Gastl, B. 702, 1143

Gattenlöhner, S. 965

Gaube, R. 650

Gauer, T. 134

Gauß, G. 431

Gauler, T. 1070

Gaulton, Kyle J. 1138

Gauss, Silja 1095

Gawish, A. 1123, 1126

Gebauer, J. 35, 145, 207, 240, 675

Gebauer, N. 419

Gebel, C. 833, 842

Gebhart, M. 315

Geboes, K. 273

Gedenk, C. 236

Gehrig, A. 275

Geissler, E. 561

Geissler, J. 301

Geissler, M. 856

Geissler, Mark E. 866

Gelse, N. 878

Gempt, J. 518

George, D. 94

Geppert, C. 1124

Gerber, D. 674

Gerber, M. 1037

Gerdes, B. 856

Gerds, Aaron T. 540

Gergis, U. 43

Gerhardt, A. 308

Gerken, M. 414, 417, 581, 710

Gerlach, L. 447

Gerlo, X. 44

Germer, C.-T. 1015

Gerstenmaier, U. 732

Gerstner, G. 62

Gerwert, K. 158

Gesell, D. 195, 371

Gesewsky, L. 828

Geßner, C. 342

Geulen, J. 699

Geyer, Charles E. 1053

Geyer, L. 726

Ghadimi, M. 559, 856, 865

Ghadjar, P. 890

Ghesquieres, H. 262

Ghia, P. 278, 549, 578

Ghilotti, F. 697

Gholami, Mohammad F. 376

Ghosh, S. 1136

Gibhardt, C. 764

Gieringer, R. 647

Giesinger, J. 1011

Giesemann, N. 866

Giesen, N. 809

Giladi, M. 702

Gildemeister, J. 211

Gilks, B. 959, 960, 961

Gillen, K. 154, 183, 290, 593

Gilligan, A. 1131

Gillmore, R. 375

Giralt, S. 237, 334, 1060

Girard, N. 1022

Girard, N. 989

Gisder, D.-M. 1055

Gisinger, S. 524

Giuseppi, Ana C. 336, 1051

Gkika, E. 52, 719, 854

Glaß, B. 1054

Glagau, S. 912

Glanemann, F. 947

Glas, M. 811

Glasstetter, M. 49

Glaus, A. 1090

Glausch, M. 859, 866, 920

Gleim, N. 235

Glogner, J. 56

Glossmann, Jan-P. 271

Gmeiner, C. 796

Goerling, U. 668, 874

Goetz, Matthew P. 423, 1085

Goetze, Thorsten O. 188

Goetzenich, A. 331

Gogas, Helen J. 388

Goh, Yeow T. 784

Göhler, T. 191

Golas, M. 275, 295

Goldbrunner, R. 742, 811

Goldmann, J. 107

Gollrad, J. 709

Golpon, H. 700

Gonnelli, A. 729

Gonzalez-Carmona, Maria A. 304

Goossens, C. 541, 624

Göring, W. 239, 888

Gossler, C. 100

Gostian, Antoniu-O. 758, 808

Goto, H. 262

Goto, K. 1108, 1131

Goto, Y. 360

Götte, M. 431, 672, 916, 975, 1088

Gottlieb, Robert L. 384, 918

Gottlieb, T. 469

Gottschling, S. 1112

Götze, T. 656

Gout, J. 531, 1141, 1138

Grabarczyk, P. 800

Grabow, D. 207

Grabowski, M. 550

Grabowski, P. 48, 51, 393, 827

Grabsch, H. 767, 779

Gracian, Antonio C. 502

Grade, M. 559, 865

Gradetzke, Felia M. 15

Gradhand, E. 873

Graf, A. 452

Graf, J. 390

Graf, K. 425, 501

Grages, A. 268

Grah, C. 393, 632

Grapp, M. 178, 185

Gräsel, J. 952

Gräßel, L. 620, 661

Grassi, M. 433

Gratze, K. 49

Gratzke, C. 890

Graupe, F. 856

Greco, N. 143

Greeske, A. 760, 899

Greiß, F. 994, 1147

Greil, C. 813

Greil, R. 378, 589, 674

Greiner, J. 809

Greiner, W. 663, 777

Gretser, S. 873

Greulich-Bode, K. 699

Greve, J. 268

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Oncol Res Treat 2024;47(suppl 1):7–283 Author Index268

Grieb, G. 48, 51, 393

Griech, N. 630

Griesinger, F. 342, 576, 685, 700, 999

Griesshammer, M. 784

Grigull, L. 979

Grimm, Marc-O. 276

Grimm, T. 1146

Grisanti, S. 1056

Grochowski, P. 698

Groenvold, M. 1011

Grohé, C. 574

Grohmann, M. 75, 134, 311, 379, 528

Grootscholten, C. 273

Groschek, M. 689

Groß, J. 48, 51

Gross, C. 1132

Gross, J. 759

Groß, P. 724

Grosser, B. 698, 779

Großer, S. 984

Großerüschkamp, F. 158

Große-Thie, C. 424

Grosso, F. 574

Groß-Opho-Müller, C. 760, 899

Grosu, Anca-L. 719, 750, 880, 890

Grün, B. 813

Grundler, E. 230, 417, 439

Grünewald, Thomas G. P. 1120

Grünwald, V. 55, 95, 100, 116, 233,

455, 875, 906

Gscheidle, S. 594

Gschwend, J. 802

Guarneri, V. 196, 423

Guberina, M. 511

Guberina, N. 511, 1070

Guckenberger, M. 769

Guenzel, C. 388

Guhlich, M. 327

Gül-Klein, S. 761

Gunasekara, N. 212

Günther, S. 181, 276

Guntinas-Lichius, O. 447, 573

Gupta, C. 377

Gupta, R. 384, 918

Gupta, Ravi G. 571

Gupta, V. 914

Gupta, Vineet G. 66

Gust, R. 315

Gutbrod, M. 838

Guth, D. 107, 191

Güthlin, C. 1037

Guthrie, V. 372

Gutiérrez-Enríquez, S. 481

Gütz, S. 689

Gutzmer, R. 388

Guyon, V. 944

Ha, Hai M. 52

Haack, T. 1073, 1095

Haaf, Léonie H. 1049

Haak, F. 609, 614

Haas, S. 688

Habenberger, P. 184

Haber, A. 702

Haberl, C. 858

Häberle, L. 239, 785, 888

Häberlin, J. 636

Hackl, T. 213

Hackshaw, A. 301

Hadaschik, B. 55, 95, 116, 228, 233,

455, 802

Haderlein, M. 808

Hadoux, J. 1133

Haefner, N. 956, 958

Haensel, B. 4

Haering, C. 874

Hafemann, Mia M. 427

Haferkamp, A. 462

Haferkamp, S. 561

Hagedorn, L. 637, 692

Hagemann, I. 355

Hagemann, J. 247

Hagemeier, A. 358

Hagemeyer, B. 213

Hähling, D. 308

Hahn, S. 239, 847

Hahn, S. 770

Hahnen, E. 275

Haidinger, R. 151

Haidn, U. 1063

Haim, D. 734

Halbsguth, Teresa-V. 207, 1037

Halfen, J. 700

Halfter, K. 91

Hall, R. 989

Halle, M. 1132

Hallebach, V. 732

Hallek, M. 271, 378, 740, 760, 847, 899, 946

Haller, F. 965

Hallermayr, A. 524, 584, 803, 836, 858

Halloul, Z. 591, 597

Hallsson, L. 1049, 1134

Hamacher, L. 760

Hamacher, R. 233

Hamilton, E. 182, 214, 762, 1085

Hamm, Anna F. 828

Hamm, I. 13, 646

Hamm, J. 764

Hammerer, P. 83

Hampl, M. 355

Han, B. 1108

Han, H. 1108

Handke, A. 55

Handtke, J. 729

Hänel, M. 308, 378

Hanke, D. 655

Hänle, M. 531, 1141

Hansel, A. 573

Hansel, C. 821

Hansel, N. 1081

Hanselmann, J. 49

Hansen, Finn K. 901

Hansen, H. 934

Hansen, T. 845

Hansinger, J. 581

Harbeck, N. 49, 61, 151, 175, 196,

275, 423, 1040, 1085

Harbottle, R. 911

Hardt, A. 358

Härle, A. 1138

Harke, N. 802

Harmuth, F. 1073

Harmuth, E. 994

Harpole, D. 345

Harrison, C. 540

Härter, M. 221

Harter, P. 270

Hartkopf, A. 402, 741, 810, 931, 1040

Härtl, K. 1146

Hartmann, A. 124, 402, 810

Hartmann, N. 965

Hartz, T. 629

Hasenburg, A. 154, 183, 290, 593

Hassel, Jessica C. 715

Hatschek, T. 484

Hattenhauer, T. 875

Hatzipanagiotou, Maria E. 710

Haufschild, C. 569

Hauke, J. 275

Haupt, N. 646

Hauschild, K. 125

Hautzel, H. 756, 989, 1022

Havel, L. 62, 674

Hayati, S. 336

He, Aiwu R. 351, 708

He, F. 934

He, Z. 1057

Hechenbichler Figueroa, S. 829

Heckelmann, B. 446

Hecker-Nolting, S. 825

Heese, O. 349

Hegg, R. 175

Hegi, M. 1103

Hegmann, N. 1089

Heidelbach, J. 760, 899

Heidenreich, A. 55, 693, 778, 946

Heider, K. 375

Heiland, S. 610, 861, 867

Heimann, M. 945

Hein, R. 1090

Heindl, Ludwig M. 923, 932

Heinemann, V. 650, 711, 786, 818,

900, 1063, 1071

Heinen, J. 390

Heinen, P. 271

Heininen-Brown, M. 1074

Heinrich, G. 1040

Heinrich, S. 143

Heinzelbecker, J. 1124

Heintz, C. 803, 836

Heinzerling, L. 561

Heise, C. 634

Heise, T. 759

Heiser, L. 734

Heißer, T. 585, 651

Heisserer, B. 672

Heist, R. 360

Heisterkamp, N. 761

Heitkamp, M. 1132

Heitmeir, B. 801

Heitplatz, B. 116

Heitzer, E. 858

Hekmat, K. 1136

Held, I. 91

Held, T. 306, 938

Heldwein, M. 1136

Hellmich, M. 646

Hellmis, E. 94

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Oncol Res Treat 2024;47(suppl 1):7–283Author Index 269

Helm, B. 797

Hemicker, T. 626

Hemmati, P. 308

Hempel, E. 868, 919, 922

Henke, M. 880

Henkel, J. 577

Henninger, G. 605

Hennings, A. 629

Henrique, R. 1124

Hentschel, L. 686

Henze, F. 151

Herber, M. 492

Herbst, S. 364

Herhaus, P. 318

Hering, D. 134

Hering, K. 52

Hering, R. 853

Herishanu, Y. 278

Herkommer, K. 802

Herling, M. 76, 535

Hermann, M. 874

Hermann, S. 127, 298, 741, 931

Hermeling, S. 694

Hernández Rivas, Jésus M. 251

Hernández-Boluda, Juan C. 540

Hernandez-Ilizaliturr, F. 567

Herold, K. 699

Herold, N. 275

Herold-Mende, C. 1034

Herr, W. 673, 701

Herrlinger, U. 363, 792, 945

Herrmann, H. 450

Herrmann, J. 720

Herrmann, K. 228, 455, 511

Herrmann, M. 891

Herrmann, P. 761

Herrmann-Johns, A. 673, 701

Hessel, H. 1074

Hertel, F. 599, 724

Hertenstein, B. 378

Herter, S. 44

Herzog, J. 738

Herzog, K. 620

Hess, Gabriel F. 605, 609, 612, 614

Hess, J. 656

Heßmann, E. 876

Hester, A. 275

Hester, B. 121

Hetterich, M. 710

Hettich, J. 565

Heudobler, D. 673

Heukamp, L. 700

Heumann, P. 481, 644

Heurgué, A. 377

Heuschmann, P. 444

Heuer, V. 1055

Heurich, M. 1026

Heuser, M. 712

Heuser Preuvot, S. 322

Heydt, C. 736

Heymach, John V. 345

Heyne, S. 796

Hickmann, E. 250

Hiddemann, W. 1071

Hielscher, T. 1084

Hiensch, Anouk E. 536

Hies, J. 673

Hildebrand, B. 419

Hildebrand, Laura S. 297

Hilgendorf, I. 35, 240

Hille, A. 798

Hillemanns, P. 355, 1049, 1134

Hiller, R. 959, 960, 961

Hillmer, A. 893

Hilpert, F. 270

Hilpert, F. 860

Hilser, T. 55, 95, 100, 116, 875

Hinke, A. 188

Hinneburg, J. 786

Hinske, Ludwig C. 295, 537

Hinz, A. 1148

Hippler, M. 518

Hirschberg, L. 151

Hirsemann, A. 436

Ho, Anthony D. 688

Ho, C. 578

Hoang, L. 960, 961

Hochmair, M. 62, 345, 1018

Hodiamont, F. 195, 354, 371

Hoegen, P. 769

Höer, A. 984

Hofbauer, C. 866

Ho, A. 1133

Hoart, J. 501

Hoknecht, P. 947

Homann, C. 511

Homann, J. 600, 871

Homann, J. 306, 938

Homann, Marc S. 567, 578

Homann, T. 268, 460

Homann, W. 350, 410, 453, 544, 965

Homeister, M. 585, 651

Hofheinz, Ralf-D. 445

Hoacher, A.-M. 1049

Hofmeister, D. 1148

Höfner, T. 462

Högner, M. 748

Hogrefe, C. 49

Hohenberger, P. 255

Hohls, L. 630

Höhn, Anne-K. 959, 960, 961

Höhn, P. 770, 776

Hohwieler, M. 1076

Hoier, D. 760, 899

Holch, J. 990

Holinski-Feder, E. 524, 577, 584, 803,

836, 858, 979

Holland-Letz, T. 44

Hollerbach, S. 1055

Homayounfar, K. 1112

Holmblad, M. 375

Holtick, U. 535

Hölscher, T. 986

Holtkamp, U. 391

Holz, B. 893

Holz, K. 610, 861, 867

Holze, M. 53

Hölzel, M. 792

Holzgreve, A. 705

Holzinger, J. 493

Holzner, B. 1011

Hönig, K. 204

Honselmann, K. 446

Hopfer, O. 676

Hoppenrath, L. 744

Horak, P. 332, 449

Horenkamp-Sonntag, D. 56

Horinouchi, H. 1018

Horn, K. 748

Horn, Lars-C. 959, 960, 961

Hornburger, H. 583

Horneber, M. 813

Hornemann, B. 874

Hörner, M. 541

Hörner-Rieber, J. 769

Horny, K. 888

Hörsch, D. 1020

Horst, D. 376, 396, 1136

Hou, Helen X. 1084

Hövel, P. 874

Hoyer, H. 355

Hoyer, Philine-S. 962

Hriskova, K. 670

Hsieh, Meng-C. 363, 792

Hu, M. 1133

Huang, C.-S. 1053, 1085

Huang, L. 468

Huberth, L. 116

Hübner, G. 689

Hübner, H. 483, 484, 541, 624

Hübner, J. 213, 458

Huemer, F. 62

Huesmann, S. 402, 810

Hufnagl, C. 493

Hughes, M. 278

Hühnchen, P. 994

Huhnold, Laura M. 764

Hummel, H.-D. 965

Hums, Anna-B. 573

Hunger, T. 135

Huober, J. 423, 1085

Hurvitz, Sara A. 214

Hüsing, J. 848, 882

Hussain, M. 37, 74, 83

Hutchinson, K. 1075

Hüttmann, A. 378

Huwa, L. 837

Huwer, S. 931

Hyeong Lee, K. 1056

Hyung, Woo J. 1000

Ianotto, Jean-C. 251

Ibrahim, N. 182

Idel, C. 268

Idler, C. 768

Ihle, Michaela A. 521, 736

Ihle, P. 56

Ihrig, A. 878

Iida, S. 1060

Ikeda, M. 372

Ilin, L. 634

Illerhaus, G. 187, 809

Illert, L. 620, 661

Illmer, T. 331

Im, S.-A. 1075

Ingermann, J. 803, 836

Inwald, Elisabeth C. 710

Iqbal, M. 674

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Oncol Res Treat 2024;47(suppl 1):7–283 Author Index270

Iro, H. 758, 808

Isfort, S. 467

Isaev, P. 1133

Isgandarov, A. 95

Ishaque, N. 305

Italiano, A. 995

Ivanyi, P. 55, 100, 875, 906

Iwata, H. 175

Izutsu, K. 262, 549, 578

J. Chisamore, M. 1056

Jacob, Anne S. 589

Jacob, Noelle S. 729

Jacobasch, L. 188

Jaeger, B. 755

Jaehde, U. 80

Jaehnig, T. 1122

Jafari, A. 304

Jagadeesh, D. 549, 578

Jagannath, S. 237, 1060

Jäger, B. 275

Jäger, E. 425, 501

Jäger, M. 599, 724

Jäger, U. 262

Jahn, P. 1088

Jagla-Franke, M. 215

Jäkel, N. 186

Jakob, D. 661, 741

Jakob, J. 255

Jakobs, F. 418, 525, 965

Jakobs, J. 697

James, D. 343

Janjigian, Yelena Y. 70, 1000

Janni, W. 402, 732, 801, 810,

917, 1040, 1122

Janoski de Menezes, J. 995

Jänsch, R. 621

Jansche, R. 801

Jansen, L. 573

Jansen, L. 255, 931

Jansky, M. 371

Janssen, Klaus-P. 694, 726, 814, 852

Janssen, M. 116

Janssen, S. 528

Janssens, A. 278

Jarzab, B. 1133

Javorniczky, R. 620

Jayavelu, Ashok K. 712

Jayne, S. 817

Jazmati, D. 358, 854

Jechorek, D. 597, 621, 757, 844

Jegannathen, A. 61

Jelgersma, C. 396, 1143

Jenke, Robert G. 901

Jens Peter, von K. 267

Jensch, A. 187, 809

Jensen, W. 240, 1088

Jentschke, E. 170

Jentschke, M. 1049, 1134

Jentzsch, M. 76, 359, 676

Jerónimo, C. 1124

Jeschke, U. 295, 537

Jhaveri, K. 1075

Jiang, P. 358

Jilg, Cordula A. 890

Jochem, L. 860

Joensuu, H. 37, 74

Johannsen, M. 868, 919, 922

John, U. 190, 843

Johnson, H. 804

Johnston, Stephen R.D. 196, 423, 1085

Jöhrens, K. 734

Jokisch, F. 694

Jonas, C. 521, 736

Jonášová, A. 336, 1051

Jonigk, D. 184

Joos, M. 53

Joos, S. 17, 256, 347, 813

Jordan, K. 445

Jost, Jo. 1081

Jorzick, C. 406, 737

Joussen, A. 709

Juhasz-Böss, I. 599, 661, 719, 724, 741,

795, 931, 944

Juhnke, S. 819

Jünemann, B. 798

Jung, J. 620, 661

Jung, Kyung H. 175

Jung, W. 589

Junghanß, C. 308, 366, 424, 1089

Jungmann, P. 741

Jungnickel, B. 926

Junker, M. 462

Junker, K. 1124

Jurczak, W. 278, 549, 567, 578

Juric, D. 1075

Jurkschat, R. 884

Justenhoven, C. 211, 219, 298, 714

Kaag, D. 15

Kaaks, R. 481, 802

Kaatsch, P. 56

Kachel, P. 476, 635

Kadel, S. 583

Kaess, C. 759

Känger, K. 452, 506

Kaftan, H. 447

Kager, L. 825

Kahl, B. 262

Kahl, C. 308

Kahl, T. 228

Kahn, J. 368

Kähnert, H. 564

Kaina, B. 1103

Kajüter, H. 95, 233, 298, 848, 882

Kal, J. 304

Kalil, Andre C. 384, 918

Kalinauskaite, G. 551

Kalinowski, U. 366

Kalinsky, K. 1075

Kalmadi, S. 674

Kalmbach, N. 346, 364, 668, 912

Kamdar, M. 278

Kämmerer, P. 160, 647

Kämpfe, D. 186, 308, 1089

Kamps, M. 890

Kang, Yoon-K. 367, 377

Kania, M. 502

Kansy, B. 704, 717

Kanz, F. 636

Kao, S. 62

Kappelmann, L. 975

Karamouzis, M. 70

Karbe, Anna-G. 396

Karli, T. 614

Karlsson, K. 278

Karpel-Massler, G. 806

Karpinski, M. 848, 882

Karras, F. 757, 844

Karthaus, M. 445

Kasahara, N. 325

Kaschdailewitsch, E. 256, 347

Kasdorf, A. 992

Käsmann, L. 358, 415

Kasper, B. 255, 686

Kasper, P. 847

Kasper, S. 492

Kasper-Virchow, S. 875

Kästner, A. 350, 544, 965

Katalinic, A. 1130

Katalinic, D. 615, 675, 739

Katalinic, M. 615

Kather, A. 958

Kathleen S, K. 665

Katz, J. 335

Kaumann, P. 503, 977

Kaumann-Guerrero, D. 885

Kaumann, L. 1019

Kaufmann, J. 358

Kaufmann, M. 768

Kaul, D. 291, 368, 396, 729, 1143

Kaul, M. 62

Kaur, S. 557, 572

Kauth, V. 462

Kawaoka, T. 351

Kawashima, J. 540, 784

Kaya, S. 647

Kayser, G. 618

Keam, B. 1133

Kearney, M. 181, 276, 745

Keck, T. 446

Keeperman, Karen L. 336, 1051

Keil, F. 378

Keilholz, U. 305, 332, 449, 645, 649,

690, 735, 1136

Kelch, S. 346

Keller, U. 332, 449

Kelley, K. 351, 377

Kelly, Ronan J. 273

Kemper, M. 246

Kemper, M. 734

Kendel, F. 283, 408, 409, 787

Kerek-Bodden, H. 629

Keric, N. 518

Kerkho, A. 589, 947

Kerßenboom, R. 697

Kersting, D. 455

Kersting, S. 892

Kesch, C. 228

Keßler, Almuth F. 518

Keßler, T. 524, 584, 803, 836

Kesting, M. 933, 939, 942, 950

Kesting, S. 990

Kestler, A. 856, 884, 1122

Kestler, H. A. 1122, 1141

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Oncol Res Treat 2024;47(suppl 1):7–283Author Index 271

Kevric, M. 825

Khalmurzaev, O. 1124

Khamis Hassan, A. 996

Khan, J. 94

Khan, N. 94

Khandanpour, C. 712, 748, 828

Kiechle, M. 275, 452, 468, 506

Kiehl, F. 916

Kiehl, M. 676

Kiermeier, S. 77, 127

Kiesslich, T. 493

Kiewe, P. 308

Kiladjian, Jean-J. 251

Kim, Jee H. 370

Kim, Jin W. 66

Kim, Moon-S. 455

Kim, Sung-B. 182

kim, y. 625

Kimmich, C. 308

Kim-Wanner, Soo-Z. 249, 581

Kirchen, H. 714

Kirchho, F. 100

Kirschner, M. 239, 521

Kirste, S. 750, 890

Kisro, J. 492

Kissinger, G. 366

Kist, Andreas M. 758

Kistner, C. 153

Kitano, M. 66

Kitazono, S. 360, 989

Kitt, K. 426

Kittai, Adam S. 343

Kiver, V. 762

Klaas, O. 803, 836

Klafke, N. 813

Klapper, W. 378

Klar, E. 366

Klauschen, F. 332, 449, 965, 1136

Klausz, K. 800

Klebl, B. 184, 267

Kleesiek, J. 228, 455

Kleger, A. 531, 1076, 1138, 1141

Kleihues-van Tol, K. 581

Klein, A. 1037

Klein, E. 452, 506

Klein, I. 856

Klein, K. 283, 408, 787

Klein, L. 876

Klein, M. 56

Klier, J. 868, 919, 922

Kliesch, S. 655, 723

Klieser, E. 493

Klindworth, R. 208

Klinge, K. 748

Klinger, C. 1015

Klinghammer, K. 332, 449, 875

Klinkhammer-Schalke, M. 414, 428,

581, 629, 710

Kloecker, G. 674

Kloft, M. 767

Kloker, Linus D. 595

Klöppel, G. 1020

Klose, P. 760

Klostermann, A. 877

Kloth, M. 1129

Klotz, R. 53

Klötzer, C. 359

Kludt, E. 681

Klug, S. 357, 495, 496, 829

Klüter, S. 769

Knauf, W. 331

Knauthe, N. 859, 866, 920

Knebel, M. 411

Kneissig, M. 837

Knippen, S. 528

Knispel, E. 828

Knoblauch, R. 1022

Knödler, A. 364

Knoefel, Wolfram T 888

Knoll, M. 368

Knolle, J. 324

Knop, S. 748

Knopf, F. 862

Knott, A. 1053

Knott, M. 187, 809

Knüttel, H. 230, 439

Ko, Yon-D. 589

Kobe, C. 378, 754

Kobelt, D. 267, 761, 871

Kobleder, A. 143, 1090

Koch, A. 917

Koch, C. 668

Koch, I. 1136

Koch, M. 808

Koch, O. 493

Koch, P. 926

Koch, R. 748

Koch, T. 1089

Köchel, A. 558

Kocher, M. 742

Kock-Schoppenhauer, Ann-K. 207

Kocsis, J. 502

Köditz, Anne-K. 874

Koeksal, M. 304

Kofahl, C. 899

Koh, Y. 567

Köhler, A. 175, 492

Köhler, M. 35, 240, 285

Kohlhas, V. 664

Kokh, D. 504

Kolb, M. 1137

Kolbe, O. 665

Koll, P. 847

Koller, A. 143, 1090

Koller, J. 877

Koller, M. 701, 428, 781

Köllermann, J. 228

Kollikowski, A. 240

Kollmar, O. 605, 609, 612, 614

Kolmhuber, S. 670

Kolodynska, Z. 1120

Komor, O. 956

Komrokji, Rami S. 336, 1051

Konda, B. 672

Kondo, K. 140

Konecny, Gottfried. E. 270

König, Alexander-O. 375, 856

König, C. 524

König, F. 868, 919, 922

König, I. 145, 207, 748

König, J. 777

König, M. 296

Königsrainer, A. 595

Konsortium, N. 577

Koo, P. 335

Kopeckova, K. 1133

Kopf, H. 667

Köpke, M. 295, 537

Kopp, Hans-G. 768, 809

Köppel, M. 955

Kopp-Schneider, A. 44

Kopyltsov, E. 74

Korbenfeld, E. 1022

Körber, S. 769, 802

Korell, F. 688

Körfer, J. 901

Körner, S. 411

Kornmann, M. 856

Kortmann, Rolf-D. 821

Koschmieder, S. 784

Köster, Marie-J. 432

Kotarac, A. 305

Kotecha, R. 674

Kotzerke, J. 986

Kouka, M. 447, 573

Kowalski, C. 408, 787, 853

Kowalski, D. 62

Koziorowski, A. 755

Kraack, Lea F. 860

Krabbe, J. 93, 99

Krabbe, Laura M. 116

Krabbe, S. 994

Kraeft, A.-L. 1055

Krafcsik, M. 816

Krat, U. 228

Kragl, B. 308

Krajsová, I. 388

Krallmann, C. 723

Krämer, A. 917, 995

Kramer, K. 12, 813

Kramer, M. 55

Krämer, S. 204

Krammer-Steiner, B. 308

Kranz, P. 282

Kratz, C. 979

Kratzer, V. 650, 786

Kraus, J. 1141

Krause, K. 1020

Kraus, T. 93, 99

Krause, F. 425, 501

Krause, Jan K. 629

Krause, M. 734, 986

Krauß, L. 559

Krawczyk, N. 917

Kraywinkel, K. 496, 629, 1130

Krebs, S. 687

Krege, S. 499

Kreissl, S. 378

Kreitz, S. 336, 1051

Krell, V. 994, 1147

Krekeler, C. 246

Kremeike, K. 557, 572

Krepper, D. 1005

Krentzke, M. 396

Kreuser, Anna L. 327

Kreutz, R. 994

Kreutzer, J. 897, 902, 962

Kreuzberg, N. 847

Kreyer, R. 954

Krieg, Sandro 1084

Krieger, J. 276

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Oncol Res Treat 2024;47(suppl 1):7–283 Author Index272

Krieger, T. 13

Kriegmair, M. 913

Krilaviciute, A. 802

Krimm, S. 89

Krishna, A. 342

Kristensen, Vessela N. 484

Kristiansen, G. 802

Kristina, R. 764

Kröger, B. 256, 347

Kroh, B. 89

Krohn, M. 316

Kroll, L. 956

Kroll, T. 926

Krombholz, A. 975

Krolo-Wicovsky, F. 190, 843

Kron, A. 350, 544, 965

Kron, F. 350, 403, 418, 482, 525, 544

Kronawitter, U. 650

Krönke, J. 748

Kronziel, L. 145

Kropf-Sanchen, C. 636, 947

Kröplin, J. 436

Kruck, S. 913

Krueger, G. 912

Krug, D. 854

Krug, J. 657

Krug, K. 842

Krüger, M. 324

Krüger, M. 160

Krüger, R. 657

Kruger, S. 88

Krüger, S. 1058

Krull, A. 78

Kruschel, I. 833

Kruszewski, M. 620, 661

Kubasch, Anne-S. 359

Kubiak, K. 107

Kubin, Thomas W. 181

Kuchelmeister, K. 945

Kuchen, R. 518

Küchler, S. 750

Kuczyk, Markus A. 802

Kudo, M. 351, 377

Kuehn, C. 760

Kuehnel, J. 954

Kufel-Grabowska, J. 536

Kühle, R. 306, 938

Kuhlmann, L. 1086

Kühlwein, J. 1141

Kühn, A. 690

Kühn, F. 1015

Kühn, J. 620, 1147

Kühn, Jan P. 411

Kühn, M. 333, 547

Kuhn, S. 667

Kühn, T. 295, 537

Kühne, T. 825

Kühnel, S. 469, 510

Kuhnigk, K. 958

Kuhnt, S. 796

Kuhnt, T. 52

Kuiper, B. 168

Kumar, A. 567

Kümmel, S. 214, 1075

Kunadt, D. 712

Kunc, K. 632

Kunhardt von Schmidt, L. 305

Kunzke, T. 1079

Kunzmann, V. 856

Kuon, J. 689

Kupka, J. 647

Kupka, T. 782

Küpper-Nybelen, J. 56

Kurland, E. 265

Kurland, John F. 1000

Kuroda, H. 345

Kurowski, K. 724, 795, 944

Kurte, Melina S. 403, 418, 482

Kuruvilla, J. 262

Kurz, Felix T. 610, 861, 867

Kusch, M. 560

Kuss, I. 37, 74, 83

Kussel, T. 581

Kuzdzal, J. 273

Kuzinska, Matylda Z. 761

Kyte, Jon A. 484

Kyung Cho, E. 1056

Laack, Heinz-E. 689

Laban, S. 268, 460

Lablans, M. 581

Labohm, L. 1130

Labuhn, S. 239, 888

Lachowicz, M. 212

Laing, E. 390

Lakes, J. 298, 802

Lamanna, N. 549, 578

Lamberti, C. 1055

Lambrecht, L. 885

Lambrecht, M. 481

Lampe, B. 107

Lamrani, A. 358

Lan, L. 360

Landgraf, C. 594

Laner, A. 577, 803, 836

Lanfranconi, F. 672

Lang, K. 221

Lang, S. 704, 717

Lange, Hans C. 211, 219

Lange, M. 969

Lange, S. 514

Lange, T. 52

Langenkamp, Ulrich I. 308

Langer, C. 674

Langer, T. 747

Langer, T. 56, 145, 207, 630, 675

Langer, V. 647

Langewitz, W. 646

Langheinrich, Melanie C. 892

Langley, R. 779

Lapshyn, O. 446

Larsen, J. 334

Laryionava, K. 833, 842

Lassmann, S. 661

Latif, U. 764, 876

Lau, G. 377

Lauer, U. 595

Lavie, D. 251

Layer, K. 994

Le Tourneau, C. 301

Leal, T. 674

LeBlanc, R. 335

Lech-Maranda, E. 549, 578

Ledig, S. 275

Lee, C. 372

Lee, Dae H. 999, 1018

Lee, E. 918

Lee, Jong-S. 62, 571, 1018, 1022

Lee, Kang-Y. 345

Lee, Ki H. 571

Lee, S.-H. 1022

Lee, Sung E. 784

Lee, Y. 372, 1138

Lee-Hoeich, Si T. 251

Leha, A. 839, 897, 902, 962

Lehle, S. 484

Lehmann, J. 88, 590

Lehmann, R. 582

Lehmann-Emele, E. 195, 371

Lehmann-Laue, A. 456

Lei, G. 1075

Lei, M. 70, 273

Leibbrand, B. 564

Leichnitz, C. 632

Leinert, E. 275

Leisz, S. 123, 124, 125

Leithäuser, M. 308

Leithner, A. 825

Leitner, T. 748

Leitsmann, M. 499

Leitzmann, M. 701, 1088

Leminski, C. 557, 572

Lemke, J. 359

Lensker, P. 109

Lentz-Hommertgen, A. 769

Lenz, G. 246, 712, 947, 1054

Leplow, B. 486

Lesniak, J. 1079

Letsch, A. 828, 860, 866

Lettmaier, S. 311

Leu, M. 327

Leukel, P. 1103

Lewerenz, J. 426

Lewis, David J. 567, 578

Lewis, J. 267

Ley, M. 535

Leyerer, K. 280

Li, D. 934

Li, H. 62

Li, J. 336, 934

Li, J. 549

Li, J. 708

Li, J. 1051

Li, L. 571

Li, M. 769

Li, R. 37, 83

Liang, L. 495

Liberman, M. 1000

Lichius, K. 558

Liebau, Emma R. 154, 593

Liebscher-Koch, S. 780

Liepa, Astra M 196

Lier, M. 819

Liermann, J. 769

Liersch, P. 798

Liersch, T. 798, 897, 902, 962

Liese, J. 436

Liesfeld, B. 584

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Oncol Res Treat 2024;47(suppl 1):7–283Author Index 273

Lièvre, A. 273

Lim, Jhin J. 682

Lim, S. M. 999

Lin, Chien-C. 336, 1051

Lin, N. 182

Lin, Y. 237, 1133

Lin, Yi-L. 821

Lindberg-Scharf, P. 428

Linde, P. 754

Lindenberg, T. 862

Lindenmayer, J. 531, 1141

Lindner, K. 468

Linge, A. 734

Lingenhöl, F. 491

Lingohr, P. 304

Link, T. 323

Linke, B. 432

Linnebacher, M. 316

Linxweiler, M. 411

Linz, Valerie C. 154, 183, 290, 593

Lipka, K. 271

Lipke, J. 966

Lipp, R. 181, 745

Lisberg, A. 360, 989

Liste Hermoso, M. 175

Liszkay, G. 388

Liu, B. 567, 1022

Liu, C. 360

Liu, H. 578

Liu, S. 62

Liu, T. 70

Liu, Y. 251

Lo Russo, G. 999

Lobmann, R. 187

Lobo, J. 1124

Locher, M. 577

Löck, S. 986

Lodes, U. 550

Loertzer, H. 1124

Loes, K. 767

Löer, M. 316

Loges, S. 352, 514

Lohaus, F. 986

Lohmüller, L. 256, 347

Lohneis, P. 88

Löhr, P. 698

Lohse, S. 1124

Loi, S. 1075

Loibl, S. 214, 1053, 1075

Lonardi, S. 502

Loong, H. 1108

Lopez, N. 251

López-Pleguezuelos, C. 481

Loquai, C. 388

Lordick, F. 492, 901

Lorenz, R. 1040

Lorenzato, A. 305

Lorenzen, S. 492

Lorusso, D. 270

Losa, F. 995

Löser, H. 88

Loskutov, J. 682

Losonczy, G. 62

Lotz, B. 283

Lotz, J. 834, 839

Lu, S. 1022

Lubig, S. 96, 744

Lucas, M. 803, 836

Lucia, A. 672

Lucius, H. 20

Lüdecke, R. 1026

Lüdecke, G. 1026

Lüdtke-Heckenkamp, K. 875

Ludwig, Jan O. 296

Lugnier, C. 1055

Lühnen, J. 786

Lukac, S. 1122

Lüke, F. 673, 781

Luna, J. 656

Lüpkes, C. 56

Lüth, F. 419

Lutz, M. 656

Lutz, Manfred P. 856

Lutz, R. 933, 939, 942, 950

Lux, Michael P. 445

Lux, S. 952

Luz, M. 265

Lymp, J. 262

Ma, S. 549, 567, 578

Maass, N. 191

Maatouk, I. 77, 127

Machtens, S. 181

Maciag, P. 335

Mackensen, A. 20

Maddocks, Kami J. 567

Madhira, V. 260

Madl, B. 1088

Maeda, P. 1133

Magee, Derek R 767

Magheli, A. 409

Mahgull, M. 388

Mahlberg, M. 796

Mahler, C. 17, 256, 347, 813

Mahn, R. 304

Mahner, S. 151

Mai, K. 994

Maier, D. 581

Maisch, P. 913

Majchrzak-Stiller, B. 770, 776

Mak, M. 1108

Makowsky, M. 351, 370, 377

Malt, A. 305

Malter, W. 536, 760, 946

Mamounas, E. 1053

Manapov, F. 415

Mańczak, A. 304

Mandalà, M. 388

Mandic, R. 325

Mandlmeier, F. 468

Manettas, A. 143

Mangum, C. 283

Manier, S. 43, 237, 334, 1060

Manjunath, A. 468

Mann, B. 536

Mann, H. 345, 1000

Mano, M. 1053

Mansmann, U. 858

Mantke, R. 892

Manz, K. 410, 453, 984

Mao, W. 1018

March, C. 517, 619, 621

Marcovitz, M. 370

Marella, N. 578

Margraf, C. 990

Maria Barbui, A. 262

Marienfeld, R. 732

Maringa, M. 275

Märkl, B. 698, 779

Markus, F. 700

Marmor, Y. 260

Marquard, S. 896, 930

Marquardt, Jens U. 675

Marschall, U. 56

Marschner, N. 49

Marsden, D. 342

Marten-Mittag, B. 1146

Martens, J. 902, 962

Martens, Uwe M. 278, 301

Martin, S. 378

Martín, M. 196, 423, 762, 1085

Martinez, M. 1022

Martus, P. 813

Mascaux, C. 989

Masi, G. 370

Maßmann, A. 839

Mateos, Maria-V. 237, 334

Materna, L. 100

Mateska, I. 734

Mathas, S. 378

Matheny, S. 214

Mathies, V. 663

Mathis, M. 661

Matschke, J. 311

Mattarei, J. 399

Mattheis, S. 704, 717

Matthes, H. 48, 51, 632

Matthes, M. 759

Matuschek, C. 854

Matveev, V. 1124

Mauch, C. 847

Mauch, H. 17

Maurer, A. 521

Maurer, J. 326, 845

Maurer, L. 994

Mäurer, M. 52, 134, 358

Mausbach, A. 116

May, A. 212, 536

May, Claus J. 324

Mayer, B. 91, 838

Mayer, B. 816

Mayer, K. 1020

Mayer-Steinacker, R. 732

Mayr, A. 80

Mayr, C. 493

Maywald, U. 276

McCoon, P. 372

McIntyre, K. 196

McKinney, M. 578

McKiver, Mihaela P. 1060

McLornan, D. 784

Medenwald, D. 52, 134, 164, 513, 517, 621

Medlin, J. 828

Meesters, S. 557, 572

Mehlhorn, G. 355

Mehlis, K. 663, 777, 842

Mehlitz, M. 518

Mehmeti, F. 402, 810

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Oncol Res Treat 2024;47(suppl 1):7–283 Author Index274

Mehnert-Theuerkauf, A. 456, 796, 874, 1148

Meier, I. 56

Meier, K. 435, 751

Meier, S. 878

Meier-Rosar, F. 901

Meier-Stiegen, F. 917

Meinert, Fabian M. 994

Meisel, C. 275

Meißner, C. 721

Meissner, J. 318, 378

Meißner, W. 325

Meister, L. 866

Meixensberger, J. 518

Mekan, S. 1056

Mela, P. 838

Melchior, F. 793

Melekian, B. 107

Melhem, A. 363, 792

Melzer, M. 1122, 1138

Melzner, A. 271

Memenga, P. 594

Menck, K. 246

Mendes Wefelnberg, M. 923, 932

Mendez, G. 273

Meng, K. 444

Mennig, E. 187

Menold, N. 663

Menrath, I. 630, 675

Mercan, S. 764, 876

Mercier, D. 462

Mergel, F. 402, 810

Mergenthal, K. 1037

Merkelbach-Bruse, S. 521, 716, 736, 774,

778, 893, 1136

Merker, K. 984

Merta, J. 854

Merz, M. 308

Merzenich, H. 56

Mesa, R. 784

Messer, Sarah L. 391

Method, M. 270

Metz, A. 295

Metz, C. 35

Metzeler, Klaus H. 359

Metzenmacher, M. 511, 574, 756, 1070

Metzger, P. 661

Metzger, R. 856

Metzler, M. 109

Meyer, B. 452, 506, 1084

Meyer, C. 346

Meyer, F. 517, 542, 550, 591, 597,

619, 621, 765, 940, 954

Meyer, M. 704, 717

Meyer-Feil, T. 878

Meyers, O. 576

Meyer-Wilmes, P. 107

Michaelis, S. 207

Michaelis, S. 946

Michaud, C. 995

Michel, Maurice-S. 499

Michl, P. 634

Michlíková, S. 734

Mielke, S. 262

Miething, C. 620, 661

Migliorino, Maria R. 1018

Mihaljevic, A. 595

Mihm, S. 427

Miinalainen, I. 926

Mijatovic, M. 873

Milani, V. 151

Milanowski, J. 674

Mildenberger, V. 350, 544

Mileshkin, L. 995

Milke, V. 557, 572

Milsom, M. 952

Milzer, M. 77, 127

Mingchao, X. 1074

Mink, J. 1124

Miranda, M. 343

Miranda, P. 260

Mirow, L. 253

Mirwald, M. 729, 1143

Misch, M. 396, 518, 1143

Misiak, D. 186

Mispelbaum, R. 875

Mitchell, R. 723

Mitschke, S. 1129

Mitsudomi, T. 345

Mittendorf, E. 175

Mix, M. 890

Mizutani, H. 571

Moccia, A. 378, 589

Mocek, A. 984

Moch, H. 995

Mock, A. 332, 449

Modest, Dominik P. 188

Moeller, R. 186

Moench, K. 462

Mohamed, A. 37

Mohammad, F. 149

Mohammad Nejad Farid, K. 771

Mohammed Abdou, M. 657

Möhler, M. 70, 140, 273, 367, 1000

Mohm, J. 966

Mohr, M. 947

Mohr, R. 582

Möhring, C. 304

Moka, Prof. Dr. D. 756

Molena, D. 1000

Molinero, L. 175

Moll, M. 932

Moll, M. 419

Möller, L. 95, 233, 848, 882

Momeni, S. 667

Mongondry, R. 672

Monin, Malte B. 304

Monin, R. 702

Monninkhof, Evelyn M. 536

Monroy Ordonez, Elsa B. 880

Moon, K. 965

Moore, K. 270

Moraitis, A. 228

Morakis, P. 504

Moratin, J. 306, 938

Moreau, P. 237, 334, 1060

Morgans, A. 94

Morkel, M. 305

Morlok, D. 1088

Morlot, S. 275

Morouj, B. 984

Morris, S. 62

Morschhauser, F. 262

Mörtl, B. 656

Mößner, U. 1090

Motoyama, S. 273

Mourão, J. 1022

Mozaari, E. 384, 918

Mpofu, P. 455

MTB-FR Network 620, 661

Mück, C. 990

Muegge, Lars-O. 308

Muenst, S. 605, 612

Mühlberg, R. 35, 208, 247

Mühle, C. 906

Mühler, M. 1049, 1134

Mühling, B. 636

Müller, A. 447

Müller, E. 385

Müller, F. 20

Müller, H. 318

Müller, J. 536, 715

Müller, Jörg-A. 52, 164, 1011

Müller, L. 492

Müller, M. 385

Müller, S. 758, 808

Müller, T. 770, 776

Müller, V. 49, 402, 810

Müller, V. 1040

Müller-Huesmann, H. 689

Müller-Tidow, C. 688, 771, 911

Mumm, F. 650, 786, 877, 990, 1071

Mummey, H. 1138

Munir, T. 278, 549, 567, 578

Munoz-Fernandez, M. 1085

Munzert, F. 956

Muro, K. 1000

Muth, C. 687

Na, Il-K. 1136

Nabet, B. 62

Nachbar, M. 551

Nacke, N. 1054

Nadji-Ohl, M. 518

Nadolny, S. 634

Nagai, H. 567

Nagai, J. 1076

Nagel, G. 268

Nair, B. 578

Nakamura, Y. 818

Nankivell, M. 779

Narosch, J. 128

Naschberger, E. 79, 657

Naser, S. 429

Nasroulah, F. 1057

Nasseh, D. 650

Nasta, Sunita D. 549, 567

Nastoupil, Loretta J. 262

Nathani, R. 140

Nauck, F. 371

Nazaré, M. 267

Necchi, A. 1057

Neemann, F. 255

Ne, A. 325

Negro, A. 351, 370, 377

Negwer, C. 1084

Neitzel, B. 577

Nekolla, E. 135

Nelson, N. 349

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Oncol Res Treat 2024;47(suppl 1):7–283Author Index 275

Neppl, S. 358

Nerger, K. 186

Nestle, U. 705

Nestler, T. 906

Nettekoven, C. 742

Nettekoven, G. 629

Neu, Marie A. 333, 547, 672

Neubauer, H. 862, 864, 917

Neubauer, M. 994

Neuberger, M. 906

Neuberger, S. 100, 906

Neuhann, T. 577, 584

Neuhaus, N. 723

Neumaier, S. 187, 809

Neumann, A. 207

Neumann, C. 645, 649, 690, 735

Neumann, F. 712

Neumann, M. 558

Neumayer, B. 493

Neumeyer, S. 357

Neumuth, T. 615

Neureiter, D. 493

Neureiter, E. 493

Neven, P. 1085

Ngo, Q. 52

Nguyen, B. 567

Nickelsen, M. 1054

Nicolay, Nils H. 235, 705

Niederacher, D. 862, 864, 917

Niedermaier, T. 585

Niedermeier, M. 188

Niederreiter, M. 838

Niederwieser, D. 76

Niegisch, G. 276

Nieland, S. 425

Niels, T. 638, 807

Nietert, M. 834

Nikolova, Z. 251

Nilius, G. 755, 756

Nishii, R. 262

Nishio, M. 571, 1018

Nkenke, E. 951

Noack, B. 256, 347

Nobbe, K. 96

Noeding, S. 49

Nogai, A. 748

Noh, Ka-W. 914

Nooka, Ajay K. 1060

Nordho, V. 655

Norris, R. 984

Nöthling, C. 724

Novak, U. 378

Novello, S. 1108, 1131

Novosiadly, R. 273

Nozaki, K. 260

Nusch, A. 49

Nyawira, B. 1053

Ober, A. 107

Oberste, M. 1064

O’Byrne, K. 571

Ochi Lohmann, T. 1018

Ochsenreither, S. 332, 449

Ocio, Enrique M. 335

Ockert-Schön, F. 751

Odenthal, M. 934

Odin, V. 15

O’Donnell, S. 711

Oechsle, K. 221, 406, 557, 569, 572,

637, 733, 737, 738

Oehme, I. 44

Oei, Shiao L. 48, 51

Oelmann, J. 327

Oeltze-Jafra, S. 782

Oertel, M. 52, 134, 1054

Oeser, A. 391

Oestreich, L. 786

Oetting-Roß, C. 613

Oh, Do-Y. 66, 372, 375, 708, 1000

Oh, S. 784

Oh, Sang C. 708

Ohmura, S. 1120

Ohnmacht, C. 662

Okamoto, I. 989

Okech, T. 4

Oldenburg, J. 1057

Oldsen, R. 185

Oliinyk, D. 901

Omari, J. 591

Omori, T. 1000

Omran, A. 267

On Behalf of the TARGET-Study

Group 650, 786

ONeill, C. 149

Onken, Julia S. 376, 396, 518, 1143

Opalka, B. 712

Opitz, B. 188

Orawa, H. 458

Oriol, A. 335

Ormanns, S. 88

Ortega, Juan Luis R. 262

Ortega Granados, Ana L. 576, 999

Ortiz-Brüchle, N. 239, 521

Ortmann, O. 629, 710

Ortmüller, F. 547

O‘Shaughnessy, J. 214, 423, 1085

Osowski, U. 181, 276, 745

Ossowski, S. 1073, 1095

Ostapenko, Y. 377, 1022

Osterborg, A. 549

Ostermann, H. 352

Ostwal, V. 708

O‘Sullivan, C. 762

Osumi, H. 305

Ott, A. 1073

Ott, S. 1090

Otte, N. 99

Otto, R. 550, 721, 954

Oubaid, N. 557, 572

Ourailidis, I. 598, 851

Overbeck, T. 700, 947

Overlach, A. 247

Ozguroglu, M. 995

Paasch, C. 765, 892

Pabst, T. 237, 334, 1060

Paepke, S. 468

Paenholz, P. 55, 100, 906

Pagel, Charlotta F. 327

Palmer, J. 784

Palomba, M. L. 262

Palti, Y. 702

Panchal, S. 1015

Panikkar, R. 674

Panse, J. 467, 1089

Pantel, K. 402, 810, 917, 1040

Pantelis, D. 1015

Paolini, S. 336, 1051

Pappesch, R. 736, 778

Papuga, J. 262

Paradies, K. 151

Pardo, L. 977

Park, Joon O. 66, 375, 426

Park, Joong-W. 351

Park, K. 1108

Passamonti, F. 540, 784

Patel, B. 540

Patel, K. 43, 237, 334, 1060

Patel, K. 260, 278, 549, 567

Patel, Manisha R. 549, 578

Patient Advisory Board (SDGC) 53

Patil, D. 793

Patnana, Pradeep K. 712

Pauer, A. 414

Pauge, S. 663

Paul, Norbert W. 672

Paulenz, I. 308

Pauli, B. 535

Pauli, C. 995

Pauli, T. 661

Pavel, M. 1020

Payakachat, N. 1131

Paz-Ares, L. 360, 571, 989

Pazo-Cid, R. 995

Peeken, J. 1084

Peipp, M. 800

Pekar, L. 800

Pelaez Puente, M. 212, 536

Pelusi, N. 965

Pelz, H. 492

Pelzer, U. 645, 649, 690, 708, 735

Peraud, A. 806

Pérez, E. 291

Perkhofer, L. 188, 531, 856, 884,

1138, 1141

Perkins, A. 784

Pérol, M. 360, 989, 1108

Perrakis, A. 619

Perrot, A. 237, 335

Persigehl, T. 590, 847

Persin, S. 599

Perualila, Nolen J. 697

Peschel, C. 468

Peters, S. 999

Petermann-Meyer, A. 467

Peters, I. 770, 776

Peters, S. 571

Petersen, C. 75

Peterson, J. 911

Peterziel, H. 44

Petridis, F. 878

Petrova, M. 375

Petru, E. 191

Petruzelka, L. 674

Petzold, A. 355

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Oncol Res Treat 2024;47(suppl 1):7–283 Author Index276

Peukert, R. 396

Pfante, O. 462

Pfarr, N. 468

Pfau, G. 940

Pfeer, S. 20

Pster, K. 402, 810

Pster, R. 946

Pfohl, U. 682

Piasecki, J. 43, 237, 334, 1060

Pichler, T. 786

Picht, T. 376

Picker, N. 656

Pickl, Julia MA. 584, 858

Picmanova, V. 672

Piessen, G. 273

Pietsch, T. 363, 792

Pietzner, K. 107, 450

Pigerl, M. 710

Pilarsky, C. 20, 653

Pilz, M. 1011

Pink, D. 686

Pirmorady, A. 994

Piscuoglio, S. 609

Pittrich, P. 814

Piwonski, I. 332, 449

Plachky, P. 211, 635

Planchard, D. 360

Platzbecker, U. 76, 336, 359, 540,

676, 1051

Pless, M. 674

Ploch, L. 333, 672

Ploeger, B. 83

Plönes, T. 574

Pluzanski, A. 571

Pochert, N. 295, 537

Poddubskaya, E. 989

Poeller, P. 1120

Poeschel, V. 1054

Poeser, P. 396

Pogoda, K. 1011

Pogoda, M. 1073

Pogorzelski, M. 875

Pöhlmann, B. 499

Pollastri, F. 1079

Polli, A. 388

Polzer, B. 917

Pongratanakul, P. 1012

Pons Tostivint, E. 360, 989

Poon, P. 774

Popova, V. 829

Popp, F. 88, 934

Popp, I. 719, 729

Porst, J. 994, 1147

Porta, Matteo G. 336, 1051

Porzelle, J. 634

Pospiech, H. 926

Potemski, P. 708

Pöttgen, C. 511

Pottho, Anna-L. 363, 792, 945

Powles, T. 1057

Pozharskaya, V. 336, 1051

Pozzo, E. 729

Pralong, A. 535, 740

Prange-krex, G. 308

Prat, A. 484

Prebet, T. 1051

Predel, Hans-G. 946

Pregler, Barbara E. F. 363, 792

Pretzell, I. 514

Preugszat, E. 88

Primus, H. 707

Printzen, S. 638

Pro, L. 247

Protzel, C. 499

Pryalukhin, A. 1124

Ptok, H. 550

Puig, Juan M. 999

Pukrop, T. 433, 673, 701, 781

Püllen, L. 228, 455

Pulst Caliman, Tilman J. 1147

Punie, K. 175

Purcea, D. 1057

Puri, T. 1108

Püschel, K. 738

Putora, Paul M. 528

Putzker, K. 267

Puzik, A. 35, 207, 240, 662

Qin, S. 66, 372

Quaas, A. 88, 716, 847, 904, 1136

Raab, M. 949

Raab, Marc S. 43, 334, 335

Rabe, A. 170

Rack, B. 402, 732, 810, 1040

Radbruch, H. 396

Radlanski, K. 319

Radosa, J. 49, 107

Raepple, S. 710

Rael, J. 838

Raghav, K. 818

Raiber, L. 12

Raje, N. 237, 334, 335, 1060

Ramage, J. 1011

Ramalingam, Suresh S. 571

Raman, I. 251

Ramlau, R. 674

Ramming, A. 79

Ramos, J. 818

Ramsenthaler, C. 670

Ran, D. 351

Ran, W. 1085

Rancati, T. 481

Randerath, W. 1136

Randrian, V. 502

Rank, A. 589, 698

Rapp, D. 426

Rapp, M. 518

Rasche, L. 583, 748

Rashid, Masturah Mohd A. 682

Raspe, M. 396

Rastogi, P. 423, 1085

Rath, M. 275

Ratjen, I. 828, 860, 866

Rattay, T. 481

Rau, B. 761

Rau, Kun-M. 708

Rau, T. 888

Rauber, S. 79

Rawluk, J. 875

Read, Stephanie H. 384

Real, C. 298

Reber, C. 612

Recher, C. 540

Reck, M. 62, 345, 571, 576, 999, 1056

Recker, F. 452, 506

Reckermann, L. 819

Redaèlli, M. 899

Redler, S. 888

Reents, N. 979

Regenbrecht, C. 653, 682

Regincos, P. 187

Regnery, S. 306, 938

Rehling, P. 764

Rehlinghaus, M. 100, 906

Reich, F. 274

Reichard, C. 819

Reichel, M. 926

Reichert, C. 782

Reichert, M. 906

Reichert, M. 650

Reif, M. 632

Reig, M. 351, 370, 377

Reiger, M. 295, 537

Reimer, A. 535

Reinacher-Schick, A. 514, 856, 1055

Reiner, M. 769

Reinhard, C. 653, 682

Reinhardt, C. 418

Reinhardt, D. 431, 916

Reinhardt, F. 862

Reinhold, T. 994

Reinisch, M. 1085

Reinmuth, N. 360, 989, 1056, 1131

Reis, A. 979

Reis, H. 95, 228

Reismann, D. 622

Reißfelder, C. 1015

Reitnauer, L. 947

Reitsam, N. 779

Reitsma, H. 168

Reitz, M. 1088

Relógio, A. 349

Renard, C. 722

Renovanz, M. 518

Rentsch, M. 858

Renz, Bernard W. 1015

Reppenhagen, Jil-C. 436

Resheq, Yazid J. 531, 1141

Restuccia, E. 1053

Reuten, R. 741

Reuter, H. 874

Reutlinger, K. 876

Reyes Cabanillas, R. 1056

Rezazadeh Kalebasty, A. 74, 83

Rhein, S. 871

Rhiem, K. 275, 280

Rhoades, Joanna M. 549

Rhodes, J. 567, 578

Ribrag, V. 251

Richardson, G. 536

Richardson, Paul G. 335

Richartz, V. 893

Richlitzki, C. 511, 1070

Richter, F. 145, 675

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Oncol Res Treat 2024;47(suppl 1):7–283Author Index 277

Richter, L. 663

Richter, M. 634

Richter, P. 250

Richter, Ricarda-C. 274

Rick, O. 327

Ricken, T. 1140

Riders, A. 1064

Ridwelski, K. 721

Riedel, F. 452, 506

Riedel, M. 450, 452, 506

Riedlsperger, M. 1049

Rieger, D. 518

Rieke, D. 332, 449, 965

Rieken, S. 327

Ries, J. 933, 939, 942, 950, 951

Ries, V. 1137

Riesch, S. 650

Rieser, T. 48, 51

Riess, O. 1073, 1095

Riethdorf, S. 917

Rimassa, L. 377

Rinderknecht, E. 55

Rink, A. 417

Riou, A. 526

Ripperger, T. 275, 979

Ristau, J. 769

Ristau, P. 613

Ritter, J. 275, 364

Ritter, T. 962

Ritter, V. 452

Ritter-Vanoorop, T. 897, 902

Ritz, A. 675

Rivandi, M. 862, 917

Rizvi, K. 672

Rizzo, C. 750

Robers, G. 410, 453

Robert, C. 388

Robertson, A. 433

Robinson, B. 1133

Roch, C. 385

Röcken, C. 446, 1058

Röderer, N. 667

Rodriguez, C. 335

Rodriguez Canales, J. 1074

Rodríguez-Otero, P. 43, 237, 334, 1060

Roeker, Lindsey E. 549, 567, 578

Roeper, J. 685, 700

Roessner, A. 757, 844

Rogahn, J. 424

Roger, E. 1138, 1141

Roggia, C. 1095

Roick, J. 634

Roig-Merino, A. 911

Rokohl, A. 923, 932

Rokutanda, N. 66, 372, 375, 708

Rolfo, C. 674

Roll, S. 994

Romic-Pickl, J. 803, 836

Ronellentsch, M. 518

Roohani, S. 52, 291, 368, 729

Roohani, Soleiman F. 729

Roos, J. 260, 343

Roos, J. 393

Rosas Romero, Juan C. 481

Rose, M. 184

Rose, M. 994

Rose, S. 336, 1051

Rösel, I. 813

Rosenau, H. 634

Rosenberger, F. 715, 812

Rosenbrock, J. 754

Rosenbusch, Marie-L. 853

Rösener, J. 1081

Rosenstein, Barry S. 481

Rosentreter, J. 435, 751

Rosenwald, A. 378

Ross, J. 995

Rössle, S. 809

Rossner, Anna-M. 450

Rotermund, T. 729

Roth, Katrin S. 754

Roth, W. 1129

Rothe, A. 966

Rothe, T. 750

Roth-Goldbrunner, S. 742

Rotmann, A. 855

Röttger, A. 630

Roubec, J. 674

Royce, T. 455

Ruane, S. 1136

Rübe, C. 1054

Rübner, M. 484, 624, 1040

Rückert, Jens-C, 1136

Ruckes, C. 672

Rudack, C. 1064

Rudlowski, C. 96, 744

Rudolph, H. 253

Rudolph, I. 707

Ruf, T. 1018

Ru, L. 1136

Rugo, Hope S. 214, 423, 1085

Ruhe, S. 458

Rühle, A. 311, 235, 358

Ruhnke, M. 181

Ruhnke, T. 56

Rundqvist, H. 536

Runnebaum, Ingo B. 355, 956, 958

Rupp, I. 990

Rupp, R. 758, 808

Ruppert, Amy S. 549, 567, 578

Russo, M. 305

Rüter, G. 745

Rütjes, A. 560

S. Abramson, J. 262

Saad, F. 37, 74, 83

Saadat Sarmadi, S. 283

Saavedra, H. 682

Sade, H. 1074

Sade, Juan P. 1057

Sadeghlar, F. 304

Safavi, F. 1056

Sagasser, J. 107, 537

Sahm, F. 1084

Saji, S. 175

Salcher, S. 315

Salchow, J. 35, 240

Salinas, G. 876

Salm, S. 1037

Salmen, J. 444

Salomo, S. 128, 213

Salzmann, N. 35, 240

Samland, L. 35, 247

San Antonio, B. 196, 1085

San Lucas Zambrano, Jennifer S. 325

Sanchez-Ibarra, Hector E. 267

Sander, A. 35, 240

Sandhu, I. 335

Sandrini, E. 769

Sands, J. 360, 989

Sangha, R. 571

Sangro, B. 351, 377

Sanhaji, M. 949

Sankarasubramanian, S. 653

Sannai, M. 926

Santarpia, L. 762

Santel, A. 720

Santini, F. 1108

Santini, V. 336, 1051

Sappok, T. 853

Saran, S. 1074

Sargin, B. 1055

Sarria, G. 304

Satoh, T. 502

Satore-Bianchi, A. 502

Satragno, C. 729

Sauer, C. 659

Sauer, S. 911

Sauer, T. 688, 771, 911

Sauerbrunn, N. 558

Saura, C. 1075

Scafa, D. 52

Scartoni, S. 182, 214

Schaaf, M. 188

Schablack, A. 239

Schad, F. 48, 51, 393, 827

Schadendorf, D. 388

Schäfer, C. 1112

Schäfer, Fritz K.W. 1058

Schäfer, H. 880

Schäfer, K. 486

Schäfer, Karl-L. 888

Schäfer, N. 1015

Schäfer, S. 1146

Schäeler, N. 390

Schäer, H. 402, 810, 931

Scharath, N. 501

Scharin, V. 838

Scharin-Nabe, D. 622

Schäfsmeier, L. 738

Schäker-Hübner, L. 901

Schallenberg, S. 1136

Schanz, J. 798, 962

Schanze, D. 584

Schaper, T. 515

Schardey, J. 1015

Scharf, F. 803, 836, 858

Scharl, M. 657

Scharl, S. 816

Scharnweber, A. 675

Schaser, J. 831

Schatz, S. 417

Schatz, S. 660

Schaub, V. 378

Scheele, J. 462

Scheer, M. 123, 124, 125

Scheer, M. 239, 893, 965

Scheold, K. 692

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Oncol Res Treat 2024;47(suppl 1):7–283 Author Index278

Scheibenbogen, C. 994

Scheid, C. 237, 334, 540, 697, 1060

Scheller, C. 123, 124, 125

Schellerer, Vera S. 79

Schenk, M. 615

Schenker, H. 1086

Schenker, M. 571, 999, 1057

Schepers, C. 535

Schepper, F. 720

Scherbring, S. 355

Scheungraber, C. 355

Schick, B. 411

Schick, M. 1074, 1079

Schiebeck, L. 456

Schieferdecker, A. 557, 572

Schiele, S. 779

Schiewer, V. 560, 687

Schier, E. 433

Schimann, L. 35

Schiner, Conrad-J. 542

Schildberg, C. 765

Schildhauer, P. 123, 124

Schildmann, J. 634, 777, 842

Schilling, B. 561

Schilling, G. 491, 565

Schilling, Merle N. 215

Schilling, O. 446

Schillinger, G. 965

Schimanski, Carl C. 856

Schimanski, S. 583

Schimmöller, L. 802

Schindler, V. 809

Schinköthe, T. 151

Schinwald, N. 455

Schirghuber, E. 301

Schirmacher, P. 598, 851

Schlaak, M. 396

Schlachtenberger, G. 1136

Schlack, K. 55, 100, 116, 181, 906

Schlageter, E. 1055

Schlatt, S. 723

Schlensog, M. 888

Schlichtig, K. 22, 80, 109

Schliephake, H. 503, 977

Schlosser, A. 316

Schlößer, Hans A. 88, 590, 754

Schlüfter, C. 667

Schlüter, K. 812

Schmalenberg, H. 308

Schmallfeldt, B. 450

Schmeer, R. 1019

Schmid, B. 79

Schmid, L. 828

Schmid, M. 1071

Schmid, P. 1075

Schmid, Y. 1122

Schmidt, Christian A. 800

Schmidt, G. 1074, 1079

Schmidt, H. 630

Schmidt, H. 1011

Schmidt, M. 61, 154, 183, 290, 593

Schmidt, M. 77, 127, 210, 536, 955

Schmidt, N. 605

Schmidt, S. 660

Schmidt, S. 324

Schmidt, T. 526, 860, 1088

Schmidt-Graf, F. 518

Schmidt-Hegemann, Nina-S. 705

Schmidt-Hieber, M. 308

Schmitt, A. 17, 256, 347

Schmitt, A. 688, 771

Schmitt, Andreas M. 612

Schmitt, J. 581, 686

Schmitt, M. 688, 771, 911

Schmitter, C. 358

Schmitz, M. 355, 573

Schmitz, N. 1054

Schmitz, S. 181

Schmoor, C. 741

Schmutzler, Rita K. 275, 280

Schnabel, A. 385

Schnabel, F. 359

Schnabel, M. 55

Schnee, M. 841

Schneeweiss, A. 1040

Schneider, C. 559

Schneider, E. 560, 696

Schneider, F. 537

Schneider, F. 735

Schneider, G. 378, 589

Schneider, G. 559, 865

Schneider, J. 812

Schneider, M. 295, 537

Schneider, M. 363, 792, 945

Schnelzer, A. 107

Schnoor, M. 675

Schoenhals, S. 724

Schoer, O. 581

Schöski, O. 650

Scholl, I. 221, 379

Scholl, S. 589

Scholz, C. 594

Scholz, C. 308

Scholz, N. 550

Schomäcker, K. 754

Schömig-Markiefka, B. 716

Schön, Anna P. 786

Schönberg, M. 1071

Schöne, N. 246

Schönfelder, R. 868, 919, 922

Schönlein, M. 247

Schöpe, Paul C. 267

Schörner, S. 158

Schrader, Andres J. 116

Schrader, J. 1020

Schrader, M. 499

Schran, S. 88

Schranz, M. 212, 518, 878

Schreier, J. 757, 844

Schreyer, K. 1146

Schrickel, J. 4

Schröck, E. 594, 979

Schröder, A. 311

Schröder, J. 275, 868, 919, 922

Schröder, M. 154

Schröder, M. 424

Schröder, W. 693, 754

Schroeder, C. 275, 979, 1073, 1095

Schröer, S. 1137

Schroers, R. 589

Schrof, S. 551

Schröter, P. 306, 938

Schubert, Maria-L. 688

Schuhbaur, Jasmin S. 504, 856

Schuit, E. 168

Schulat, C. 697

Schuler, M. 686

Schuler, M. 511, 965, 1022, 1070

Schuler, P. 460

Schüler, P. 897

Schüller, U. 729

Schulte, C. 181

Schulte, T. 1148

Schulte-Hürmann, H. 565

Schulz, A. 55

Schulz, H. 557, 569, 572, 692

Schulz, M. 853

Schulz, M. 429

Schulz, M. 1129

Schulz, S. 219

Schulz, V. 693

Schulze, A. 1120

Schulze, Arik B. 246

Schulze, Lara-M. 153

Schulze, S. 153, 186, 308, 424, 1089

Schumacher-Wulf, E. 49

Schumann, C. 345, 689

Schumann, L. 1130

Schupp, L. 720

Schürger, N. 95

Schürmann, Elisa K. 864

Schürmann, M. 780

Schuss, P. 945

Schuster, S. 35, 207, 240

Schuster, S. 622, 793

Schütte, W. 62, 947

Schütz, E. 700

Schütz, J. 504, 856

Schütz, L. 160

Schutzman, J. 1075

Schüürhuis, S. 283, 408

Schwab, J. 1122, 1141

Schwab, R. 154

Schwäble Santamaria, A. 433

Schwanfelder, J. 80

Schwarz, F. 831

Schwarz, M. 186

Schwarz, S. 316

Schwarzenbach, C. 1103

Schwarzer, A. 308

Schweizer, L. 368

Schwind, S. 76

Schwitlick, C. 828

Sebastian, M. 947, 965

Sebens, S. 446

Sedlaczek, P. 605, 609, 612, 614

Seeger, A. 154

Seelemeyer, F. 778

Seeling, C. 732

Segerer, F. 1074

Sehouli, J. 107, 450, 994

Seibold, P. 481, 644, 802

Seidel, C. 235

Seidlitz, T. 590

Seidl-Rathkopf, K. 455

Seifart, U. 797

Seitz, F. 673

Seitz, K. 624

Seitz, S. 710

Seitzer, K. 116

Seiz, W. 462

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Oncol Res Treat 2024;47(suppl 1):7–283Author Index 279

Seliger-Behme, C. 659

Seluzhytsky, A. 342

Sender, A. 456

Senft, C. 831

Senger, C. 551

Senkus, E. 536, 1085

Seo, Jae H. 196

Seog Kim, W. 567

Serpa, M. 750

Serrano, M. J. 524

Sers, C. 305

Sethi, S. 1022

setyono, E. 862

Seuerlein, T. 188, 504, 531, 629, 732,

853, 856, 884, 1122, 1141

Seuthe, K. 847

Seymour, John F. 549, 567, 578

Sezer, E. 708

Shacham Abulaa, A. 251

Shah, Nirav N. 549, 567, 578

Shah, R. 342

Shah, R. 1018

Shahir, A. 423, 1085

Shakar, N. 1075

Shaked, Z. 376, 396

Sharman, J. 278

Shearer-Kang, E. 175

Shelman, W. 502

Shen, L. 70

Shen, Q. 576

Sherman, E. 1133

Shetty, Jeevan K. 336

Shetty, V. 343

Shitara, K. 70, 367

Shiu, Kai-K. 995

Shore, N. 74, 94, 265

Shortt, J. 336, 1051

Shreeve, M. 1022

Shum, E. 360

Shumilov, E. 748

Sibert, Nora T. 853

Sichler, A. 694

Sicking, A. 917

Siddiqui, A. 1053

Siddiqui, M. 62

Siebels, M. 499

Siebenhüner, E. 994

Siebert, A. 865

Siebert, R. 732, 979

Siebert, U. 1049, 1134

Siebolts, U. 239, 736, 774, 778

Siefen, Ann-C. 403, 418, 482, 525

Siegle, A. 296

Siegmann, A. 816

Siemanowski, J. 716, 736, 774

Siena, S. 818

Siepmann, K. 590

Sievert, M. 758, 808

Sigle, A. 890

Silberg, M. 100

Silcher, C. 255

Simic, D. 350, 544

Simmins, Juan Pablo V. 462

Simon, F. 1064

Simon, J. 208

Simon, P. 333

Simon, Steen T. 535, 740

Sindern, J. 697

Singer, S. 518, 686, 878

Singh, N. 959, 960, 961

Singhal, S. 43

Sinn, M. 35, 188, 207, 240, 247

Sipos, B. 595

Sirachainan, E. 708

Sirhan, S. 540

Skarbnik, A. 278, 343

Skatkova, O. 301

Skoczylas, T. 70

Skoetz, N. 391

Slawska, J. 468

Smakal, M. 61

Smirnow, I. 595

Smith, J. 267

Smith, M. 37, 74, 83

Smith, Victoria M. 817

Smuda, A. 819

Sobrero, Alberto F. 502

Söhl, Malte F. 828

Söhlke, B. 352

Sohm, M. 188

Sohn, Joo H. 175, 762

Soinski, N. 526

Sokalska-Duhme, M. 35, 240

Sokotukhin, V. 414

Solbach, C. 275

Soldatenkova, V. 1108

Sölder, P. 385

Soleymani, S. 70

Söllner, W. 646

Solomon, B. 1018, 1108

Solomon, Scott R. 237, 334, 1060

Sommer, C. 1103

Sommer, G. 759

Sommer, M. 208

Sommer, N. 304

Sommerlatte, S. 777

Song, C. 1075

Sonke, G. 536

Sonntag, B. 646

Sonntag, M. 268, 460

Sonpavde, G. 1057

Soo Tiong, I. 336, 1051

Sookprasert, A. 375

Sookthai, D. 188

Sorg, B. 825

Sowa-Israel, M. 672

Soysal, S. 605, 609, 612, 614

Spahrkäs, S. 168

Spałek, Mateusz J. 729

Spallek, J. 866

Sparber-Sauer, M. 821

Speiser, D. 275, 283, 346, 364, 408,

409, 668, 787, 912

Sperk, E. 311, 481

Spielmann, Sarah-M. 560

Spier, A. 350, 544

Spier, I. 979

Spira, A. 1022

Spitzmüller, A. 1074

Spitzner, M. 559, 865

Spix, C. 56

Spohn, C. 186

Spohn, Simon KB. 705, 719, 750, 890

Sprave, T. 719, 880, 890

Spreaco, F. 672

Spreckelsen, C. 128

Srinivasan, D. 1138, 1141

Srinivasan, S. 37, 74, 265

Sroczynski, G. 1049, 1134

Stäbler, A. 1095

Staerk, C. 80

Stahl, M. 545, 995

Stahl, P. 616

Stähr, K. 704, 717

Staib, L. 856

Stamer, T. 675

Standvoss, K. 1136

Stang, A. 95, 233, 298, 848, 882

Stange, D. 590, 734

Starling, N. 711

Stäudle, J. 768

Stec, J. 270

Steckelberg, A. 650, 786

Stecklum, M. 600, 871

Stefanovic, M. 672

Stefanowicz, S. 311, 528

Steel, J. 729

Steens, J. 1124

Steens, K. 93

Stegen, S. 283, 408, 787

Steiger, K. 468, 598

Stein, A. 35, 240, 492

Stein, B. 646

Stein, U. 267, 761, 775

Steinbach, J. 518

Steindorf, K. 77, 127, 210, 212, 536, 955

Steinestel, J. 100

Steinger, B. 428

Steinhäuser, J. 675

Steininger, A. 468

Steinke-Lange, V. 524, 577, 584,

803, 836, 858, 979

Steinle, Julia A. 994

Steinmeier, T. 717

Stelmach, R. 55, 100, 906

Stengel, A. 390

Stenzinger, A. 598, 851

Stephan-Falkenau, S. 965

Sternberg, Cora N. 37, 74, 83

Stewart, R. 1079

Stickeler, E. 326, 845

Stilgenbauer, S. 260, 268, 549, 732, 884

Stillger, Maren N. 446

Stintzing, S. 305, 645, 649, 690,

735, 827

Stjepanovic, N. 999

Stobart, H. 481

Stock, S. 350, 544, 646

Stocker, G. 492

Stöckle, M. 1124

Stoecklein, Nikolas H. 864, 917

Stoever, I. 755

Stögbauer, F. 598, 851

Stöhr, M. 615

Stoian, Raluca G. 719, 880

Stoklossa, C. 994

Stolle, J. 424

Stolz, R. 17, 256, 347, 813

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Oncol Res Treat 2024;47(suppl 1):7–283 Author Index280

Stölzel, F. 828, 859, 860, 866, 920

Stork, T. 768

Stössel, S. 333, 672

Stout, T. 1075

Strassburg, Christian P. 304

Straube, C. 134

Strauß, A. 100

Strauss, C. 123, 124, 125

Strauss, G. 426

Strebhardt, K. 949

Strentzsch, J. 809

Strick, C. 1125

Strickler, J. 818

Strieer, Jana K. 188, 729

Stritzke, F. 306, 938

Strobel, H. 363, 806

Ströbel, P. 700, 876

Strohbücker, B. 687

Strotmann, J. 770, 776

Strouse, B. 540, 784

Strube, K. 768

Strüder, Daniel F. 424

Strupp, J. 992

Stuck, Boris A. 325

Stuebs, F. 541, 747

Stuehrenberg, A. 452

Stuiver, Martijn M. 212, 536

Sturm, M. 1095

Stürzl, M. 79, 657

Stuschke, M. 511, 1070

Stutzki, A. 558

Su, Wu-C. 360

Suditsch, M. 1140

Sugawara, S. 62, 989

Sujenthiran, A. 455

Sukeepaisarnjaroen, W. 377

Suksombooncharoen, T. 708

Sülberg, H. 897, 902

Sulene Cunha Sousa, O. 1000

Sulzer, S. 764

Sun, K. 712

Sun, T. 1022

Sun, W. 376

Sunpaweravong, P. 351

Surace, M. 1074

Surmann, B. 663, 842

Surovtsova, I. 504

Susanne, B. 595

Sutter, C. 979

Suzuki, H. 74

Suzuki, K. 334

Swart, E. 56

Sweegers, Maike G. 212

Szijgyarto, Z. 711, 999

Szotyori-Artz, G. 504

Sztankay, M. 1005

Tabatabai, G. 518, 811

Tabernero, J. 502, 818, 1000

Tahara, M. 1133

Tahmasbi Rad, M. 949

Tak, Won Y. 370

Takahashi, H. 375, 708

Takahashi, M. 196

Takes, M. 614

Talbot, C. 481

Talbot, T. 342

Tallarek, M. 866

Tam, Constantine S. 549, 567, 578

Tam, Vincent C. 377

Tamaskovics, B. 875

Tamm, I. 49

Tan, B. 372, 708

Tanasanvimon, S. 370

Tancredi, A. 1103

Tannapfel, A. 504, 1055

Tanner, C. 143

Tanzer-Küntzer, S. 1071

Taran, Florin-A. 661, 741, 931

Tari, S. 877

Tas, K. 1126

Tatagiba, M. 518

Tatzber, A. 450

Taube, Janis M. 345

Taugner, J. 415

Tausch, E. 636

Tchaikovski, S. 107

Tecklenburg, J. 594

Tehfe, M. 70

Tehlirian, C. 251

Telli, M. 175

Ten Bokkel-Huinink, D. 536

Tenckho, S. 53

Teresi, Rosemary E. 745

Terhaag, J. 49

Terwey, Jan-H. 722

Tesch, H. 1040

Tessoulin, B. 567

Testa, L. 423

Testori, M. 1074

Tetzner, K. 630

Tewes, M. 385

Thaiss, Wolfgang M. 732

Thamm, R. 816

Thanopoulou, E. 1075

Theall, Kathy P. 182, 214

Theegarten, D. 511, 1070

Theen, S. 410

Theiß, U. 325

Theißen, T. 637

Thelen, M. 88, 590

Theodoraki, Marie-N. 268, 460

Theurich, S. 1063

Thiel, K. 595

Thiele, J. 12

Thiele, Klaus-P. 1137

Thiem, D. 160

Thilakatathne, P. 697

Thomas, C. 986

Thomas, E. 734

Thomas, M. 221

Thomas, M. 296

Thomas, M. 995

Thomas, P. 408, 787

Thompson, A. 745

Thompson, Philip A. 578

Thomsen, A. 880

Thomssen, C. 486

Thronicke, A. 48, 51, 393

Thungappa, Satheesh C. 377

Thurner, A. 1005, 1011

Thuss-Patience, P. 396

Thy, S. 1012

Tiede, A. 190, 843

Tiegges, S. 721

Tielsch-Nebel, R. 271

Tiemann, M. 660

Tiller, D. 153

Timmer, M. 742

Timmermann, B. 704, 717, 821

Timotheou, A. 304

Tinhofer-Keilholz, I. 332, 449

Tippelt, S. 821

Tischler, V. 239

Tischo, I. 1055

Todorovic, J. 876

Toetome, L. 739

Tolaney, Sara M. 196, 423

Toma, M. 304

Tomaschko, K. 813

Tomasek, J. 502

Tombal, B. 37, 74, 83

Tometten, M. 875

Tomita, Y. 1057

Toncheva, P. 750

Topp, M. 583, 589

Torgunrud, A. 761

Torke, S. 775

Tougeron, D. 372

Traidl-Homann, C. 295, 537

Trakin, A. 1085

Trappe, Ralf U. 722

Traub, F. 824

Traut, A. 545

Traut, M. 419

Trautmann, H. 76

Trautmann, K. 318

Trelinska-Finger, A. 396

Trepel, M. 779

Trevaskis, M. 536

Tribian, N. 191

Triegla, U. 308

Trillsch, F. 151

Trinks, A. 305

Trocchi, P. 56

Trojan, L. 834, 839

Trommer, M. 52, 311, 358

Trommer, S. 52

Troost, Esther G. C. 986

Troschke-Meurer, S. 800

Trumet, L. 942

Trümmler, J. 525

Truppel-Hartmann, A. 43, 237, 334, 1060

Tryfonidis, K. 762

Trzeciak, E. 160

Tsai, Donald E. 549, 567, 578

Tseng, Ying-J. 495

Tsurutani, J. 762

Tucci, A. 251

Tüchler, A. 280

Tuchscherer, A. 740, 754

Tufman, A. 885

Tumewu, T. 76

Tunn, Per-U. 825

Turner, N. 1075

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Oncol Res Treat 2024;47(suppl 1):7–283Author Index 281

Tüttenberg, A. 160

Tzankov, A. 605

Uema, D. 989

Ugocsai, P. 710

Uh, M. 1108

Uhl, W. 504, 770, 776, 856

Uhlig, A. 834, 839

Uhlig, J. 359, 492

Uhlig, J. 834, 839

Uhrig, S. 484

Uhrig, U. 267

Uibeleisen, R. 187

Ujjani, Chaitra S. 549, 567

Ulbricht, S. 366, 424

Uleer, C. 49

Ullmann, Sarah R. 757, 844

Ullrich, A. 406, 569, 572, 637, 733,

737, 738

Ulys, A. 265

Unger, C. 599, 724, 795, 944

Unger, K. 877

Unsöld, L. 296

Untch, M. 295, 537, 1053

Unterberg, A. 1034

Urban, L. 571

Uronis, H. 273

Urruticoechea, A. 536

Ürün, Y. 1057

Vaccaro, G. 375

Vachek, J. 675

Vahl, J. 268

Vajen, B. 594, 782

Vajkoczy, P. 376, 396, 729, 1143

Valcárcel, D. 336, 1051

Valderrama, Begoña P. 1057

Valentini, J. 17, 256, 347, 813

Valentini, L. 35, 208, 240, 781

Valle, J. 66, 372

Vallespir, Bartomeu P. 182

Vallet, S. 906

Van Cutsem, E. 273, 367, 818, 1000

van den Berg, N. 965

van der Heijden, Michiel S. 1057

van der Wall, E. 536

Van Gorp, T. 270

van Heteren, P. 748

van Hoorenbeeck, S. 697

van Kuijk, Sander M.J. 767

van Leeuwen-Snoeks, L. 536

Van Passen, C. 657

Vanoorop, Jana Nele L. 897, 902

Vannier, C. 191

Vannucchi, Alessandro M. 540, 784

Varela, M. 370

Varga, M. 493

Vasaturo, A. 1136

Vassiliadis, A. 946

Vatter, H. 363, 792, 945

Vay, S. 946

Vcev, A. 739

Veatch, A. 62

Vecchione, L. 305

Vedal, M. 262

Vega, A. 481

Vehling-Kaiser, U. 966

Vehreschild, Jörg J. 581

Veldeman, L. 481

Venerito, M. 1020

Venkataramani, V. 610, 861, 867

Venkateshan, S. 342

Verholen, F. 74

Vermeren, X. 821

Vermeulen, M. 1012

Verpoort, K. 966

Vetterlein, I. 926

Vettorazzi, E. 35, 240

Viardot, A. 378

Vibe, E. 803, 836

Vicente Baz, D. 1056

Vij, R. 1060

Villalobos-Bollen, M. 15, 296

Villwock, S. 184

Vitinius, F. 13, 646

Vlahovic, G. 711

Vlasenko, D. 698

Vodala, S. 336

Vogel, A. 66, 370, 372

Vogel, Marco M. E. 1125

Vogel-Adigozalov, S. 53

Vogelsang, H. 858

Vogler, M. 817, 873

Vogt, L. 425, 501

Voigt, K. 1037

Voigtlaender, M. 121

Voigtmann, R. 622

Voland, A. 1

Volchek, Y. 251

Volk, A. 275, 979

Völkel, V. 230, 417, 428, 439, 581

Volkmar, P. 590

Vollmuth, P. 610, 861, 867

Volmerig, J. 755, 756

Volodina, T. 803, 836

Voltz, R. 557, 572, 740, 992

von Ameln, S. 584

von Bergwelt-Baildon, M. 88, 590, 650, 786

von Bubno, Nikolas Christian C. 419, 675,

712, 748

von der Emde, B. 332, 449

von der Heyde, E. 492, 689, 875

von Ellerts, A. 1063

von Grundherr, J. 35, 240, 247

von Heesen, M. 612

von Kalle, C. 965

von Krüchten, R. 854

von Lehmden, M. 828

von Levetzow, C. 271, 558, 664

von Tresckow, B. 318, 418

von Tresckow, J. 121

von Witzleben, A. 268

Vordermark, D. 52, 164, 513

Vorwerk, H. 1123, 1126

Vorwerk, J. 712

Vorwerk, U. 621

Vose, Julie M. 567

Voss, M. 518

Vössing, C. 700

Vucinic, V. 58, 76, 359, 676

Vuko, M. 1074

Wabro, A. 891

Wadsley, J. 1133

Waetzig, R. 759

Wagener-Ryczek, S. 736, 893

Wagner, A. 493

Wagner, A. 1140

Wagner, Anna S. 77, 127

Wagner, J. 685

Wagner, Jenny K. 283, 346, 364, 668

Wagner, M. 411

Waha, A. 363, 792

Waha, A. 275

Wahba, R. 934

Wahidie, D. 909

Wahl, Lena M. 426

Waidhauser, J. 698

Wainberg, Z. 367, 1000

Waldenberger, D. 689

Waldschmidt, D. 188, 696, 847, 856

Walewska, R. 278

Walker, P. 278

Wallenwein, A. 873

Waltenberger, M. 52, 1125

Walther, W. 267, 761, 775

Walz, S. 187, 809

Wandke, S. 221

Wandmacher, Anna M. 446

Wang, Chen-Y. 918

Wang, C. 578

Wang, J. 140

Wang, Michael L. 567

Wang, Y. 567, 578

Wang, Y. 335

Wang, Y. 270

Wang, Z. 934

Wang, Z. 1034

Wanka-Pail, E. 135

Wansch, K. 645, 649, 690

Wappenschmidt, B. 275

Ward, J. 674

Ward, T. 481

Wardelmann, E. 246

Warfsmann, J. 917

Warta, R. 1034

Wäsch, R. 335

Wasilewski, D. 376, 396, 1143

Watolla, M. 917

Webb, A. 481

Webendörfer, M. 947

Weber, A. 709

Weber, Bernhard H.F. 275

Weber, K. 892

Weber, M. 933, 939, 942,

950, 951

Weber, V. 984

Weber, W. 681, 699

Wedding, U. 833, 842

Wedeken, L. 653, 682

Wegel, S. 761

Wegen, S. 311, 358, 705, 754

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Oncol Res Treat 2024;47(suppl 1):7–283 Author Index282

Wegener, S. 676

Weg-Remers, S. 280, 681, 699

Wehinger, J. 518

Wehner, A. 1088

Wehrle, J. 620

Wei, R. 196, 423

Weichert, W. 468, 598, 851, 965

Weide, R. 966

Weigert, A. 873

Weigmann-Faßbender, S. 866

Weikel, W. 154

Weimann, S. 134

Weinberg, U. 702

Weindler, J. 754

Weinert, K. 476, 635

Weinhold, C. 276

Weinstock, N. 979

Weisel, K. 748

Weiss, L. 657

Weiß, M. 740

Weiß, T. 632

Weiß Lucas, C. 518

Weissenstein, U. 632

Weissmann, T. 311

Weist, P. 700

Weitmann, K. 410, 453, 629

Welker, C. 990

Wellner, Ulrich F. 446

Welslau, M. 49, 121

Welt, A. 49

Welter, V. 736

Wemmert, S. 411

Wendland, K. 20

Wendlandt, M. 803, 836

Wendler, J. 809

Wendler, O. 808

Wendt, A. 956

Wengström, Y. 212, 536

Weniger, B. 432

Wennhold, K. 88, 590

Wensing, M. 842

Wenzel, G. 391

Werle, Laura R. 962

Wermke, M. 965

Werner, D. 298

Werner, J. 946

Werner, J. 91, 1015

Werner, M. 620, 661

Werner, R. 705

Wesselmann, S. 283, 629, 747

Wessendorf, S. 4

West, Catharine ML. 481

Westhofen, G. 790

Westho, Mike-A. 363, 806

Westphalen, C. B. 514, 650, 786

Weum Abrahamsen, I. 43, 1060

Weusthof, K. 306, 938

Weuthen, P. 271

Weydandt, L. 314

White, D. 335

Wick, W. 610, 861, 867

Wickenhauser, C. 951

Wiegel, T. 816

Wiegmann, J. 55, 875

Wiehle, R. 750

Wienands, J. 865

Wienke, A. 486

Wierda, William G. 278, 549, 578

Wiesmann-Imilowski, N. 160, 647

Wiesmüller, L. 402, 801, 810

Wiestler, B. 1084

Wiesweg, M. 511, 947, 1070

Wiewrodt, D. 1081

Wikert, J. 195, 354, 371

Wild, M. 295, 537

Wild, R. 893

Wilharm, C. 740

Wilke, T. 276, 656

Willborn, K. 700

Wille, K. 856

Willich, Stefan N. 994

Wilop, S. 689

Wimberger, P. 107, 323

Winder, T. 345

Windhager, R. 825

Windschüttl, S. 781

Windsor, S. 672

Winkelmann, P. 493

Winkler, E. 663, 777, 833, 842

Winkler, S. 151

Winter, Katharina S. 135

Wintner, L. 1005

Winzler, C. 504

Wirth, L. 1133

Wirth, U. 1015

Wiskemann, J. 1, 143, 536, 672, 715,

812, 955

Wismar, L. 80

Wisser, S. 1055

Witt, D. 1095

Witt, J. 1095

Witt, O. 44

Witte, C. 813

Wittel, Uwe A. 856

Wittemer-Rump, S. 83

Wittenberg, I. 164

Wittenberg, T. 913

Wittig-Sauerwein, A. 854

Wittke, K. 994

Witzmann, J. 581

Wöckel, A. 170, 444

Wohlfrom, T. 577, 803, 836, 858

Wölber, L. 355

Wolf, B. 314

Wolf, J. 271, 350, 544, 664, 693, 893,

965, 1108

Wolf, S. 610, 861, 867

Wolfarth, B. 994, 1147

Wolfer, S. 503, 977

Wol, D. 673

Wol, D. 782

Wöling, S. 594

Wolfgang, W. 600, 871

Wolfshöfer, S. 827

Wolmark, N. 1053

Wolniczak, E. 517

Wolters, H. 1055

Woodru, H. 767

Woods, N. 322

Woopen, H. 994

Worthy, G. 1131

Woyach, Jennifer A. 278, 549, 567

Wright, P. 672

Wrobel, D. 49

Wu, B. 251

Wu, C. 722

Wu, F. 43, 1060

Wu, X. 934

Wu, Yi-L. 1018

Wuerein, D. 274

Wul, B. 738

Wul, J. 704, 717

Wul, T. 860

Wulf-Goldenberg, A. 600

Wunderlich, H. 1124

Wunsch, K. 355

Wünsch, A. 646, 667, 878

Wurmthaler, L. 541, 624

Wurschi, G. 358

Würstlein, R. 151

Würzberg, P. 834

Wüstefeld, H. 393, 632

Wypyrsczyk, L. 333, 547

Wyrwicz, L. 70, 140, 1000

Xicoy, B. 251

Xing, B. 722

Xiong, J. 375

Xiong, Y. 656

Xu, J. 94

Xu, P. 636

Xu, R. 376, 396

Xu, T. 175

Xu, T. 1018

Xyländer, M. 878

Xynos, I. 1000

Yacoub, A. 540

Yakushev, I. 1084

Yamaguchi, K. 70, 367

Yamazaki, N. 388

Yan, S. 267

Yang, L. 917

Yang, S. 762, 818

Yang, S. 375

Yang, Y. 273

Yang, Z. 502

Yannakou, Costas K. 251

Yao, J. 273

Yao, James C. 502

Yao, R. 305

Yarchoan, M. 351

Yau, T. 351

Yavas, A. 785

Ye, D. 74, 1057

Yen, Priscilla K. 367

Yildirim, N. 817

Yılmaz-Aslan, Y. 909

Yoh, K. 360

Yong, Alan S. M. 343

Yong, Yong S. 79

Yoshino, T. 502, 711, 818

You, J. 345

Young, T. 1011

Yousean, S. 688

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Oncol Res Treat 2024;47(suppl 1):7–283Author Index 283

Youssef, B. 61

Yuan, Y. 571

Yücel, M. 661

Yun, Yeong C. 610, 861, 867

Yurttas, C. 595

Zacher, S. 786

Zahn, Anna L. 541

Zahn, C. 186

Zaiss, M. 423

Zamboglou, C. 705, 750, 890

Zander, T. 271, 273, 693, 754

Zapf, A. 569

Zaporozhchenko, Y. 621

Zaucha, R. 66

Zebger-Gong, H. 360, 989

Zech, Christoph J. 605, 614

Zedler, P. 910

Zeeb, H. 1088

Zeh, A. 164

Zeidan, Amer M. 336, 1051

Zeindler, J. 612, 614

Zeissig, S. 629

Zelenetz, Andrew D. 567

Zeltner, V. 710

Zeman, F. 561

Zengerling, F. 906, 1122

Zenner, HP 168

Zeuschner, P. 839

Zhang, A. 175

Zhang, D. 786

Zhang, J. 336, 1051

Zhang, J. 273

Zhang, L. 674

Zhang, W. 62

Zhang, W. 83

Zhang, Y. 989

Zhao, J. 934

Zhao, Q. 251

Zhao, Y. 934

Zhaoran, S. 316

Zhen, David B. 66

Zhong, W. 1018

Zhou, C. 934

Zhou, C. 1108, 1131

Zhou, D. 367

Zhou, T. 304

Zhou, Z. 335

Zhu, D. 335

Ziegler, David A. 327

Ziegler, S. 327

Zielonka, S. 800

Ziepert, M. 1054

Zieschang, C. 83

Zilski, N. 346, 364, 668, 912

Zimmer, E. 1138

Zimmer, N. 160

Zimmer, P. 536

Zimmermann, A. 378

Zimmermann, J. 1079

Zimmermann, T. 362, 874

Zimovjanova, M. 61

Zinnow, V. 761

Zinzani, Pier L. 549, 567

Zipfel, S. 390

Zipp, M. 1112

Zips, D. 319, 368, 551, 709,

729, 816

Zischinsky, Mia-L. 267

Zitzmann, M. 655

Zivanov, M. 61

Zocholl, D. 450

Zografos, E. 711

Zopf, E. 536

Zormaier, S. 468

Zoth, N. 946

Żotkiewicz, M. 66, 372, 708

Zschäbitz, S. 55, 100, 906

Zschaeck, S. 551, 890

Zubac, D. 807, 932

Züe, S. 182

Züger, A. 663

Zühlke, O. 368

Zukov, R. 345

Zuljan, E. 332, 449

Zünkeler, M. 650

Zurawski, B. 571

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